scholarly journals ADHERENCE TO THE 2019 FOCUSED UPDATE OF THE 2014 AHA/ACC/HRS GUIDELINE ON THE USE OF ORAL ANTICOAGULANT AGENTS IN PATIENTS WITH ATRIAL FIBRILLATION IN THE MIDDLE EAST: THE JORDAN ATRIAL FIBRILLATION STUDY

2021 ◽  
Vol 77 (18) ◽  
pp. 1520
Author(s):  
Ayman J. Hammoudeh ◽  
Nazih Kadri ◽  
Ramzi Tabbalat ◽  
Eyas Al-Mousa ◽  
Laith Habahbeh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Middle East ◽  
Oral Anticoagulant ◽  
Anticoagulant Agents

scholarly journals Women with atrial fibrillation in the Middle East: utilization of oral anticoagulant agents in a population with bad baseline clinical profiles and risk scores

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Hammoudeh ◽  
R Ibdah ◽  
S Rawashdeh ◽  
A Ababneh ◽  
A Al-Kasasbeh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Middle East ◽  
Risk Score ◽  
Oral Anticoagulant ◽  
Middle Eastern ◽  
Risk Scores ◽  
Funding Sources ◽  
Middle Eastern Women ◽  
Anticoagulant Agents ◽  
Artery Disease

Abstract Background Atrial fibrillation (AF) is the most common sustained arrhythmia in women and men worldwide and in the Middle East. Several studies have shown that women with AF are undertreated despite worse baseline clinical and risk profiles compared with men. It is largely unknown if this also applies to Middle Eastern AF patients. Purpose To evaluate baseline clinical features and utilization of guideline-recommended oral anticoagulant medications (OACs) in Middle Eastern women with AF. Methods The Jordan AF prospective multicenter study enrolled 2160 patients with AF, including 1164 (53.9%) women, in 20 hospital and outpatient clinics (May 2019 through January 2021). Results Nonvalvular AF was present in 1038 (91.0%) of women and 935 (94.6%) of men. Compared with men, women were older (mean age 69.2±11.5 years vs. 66.1±14.9 years, p<0.001), and had higher prevalence of hypertension (79.1% vs. 69.5%, p<0.001), diabetes (46.1% vs. 41.7%, p=0.04) and obesity (60.5% vs. 34.6%, p<0.001). Women, however, had lower prevalence of two comorbidities; heart failure (21.5% vs. 28.6, p=0.001) and coronary artery disease (7.7% vs. 15.4%, p<0.001) compared with men. Rate of utilization of oral anticoagulant agents (OACs) was higher in women than men with high and intermediate CHA2DS2 VASc scores (Table). Direct OACs were used in 64.0% of women and 63.3% of men with high risk score (p=NS). Multivariate analysis did not show sex to be an independent predictor of use of OACs. Conclusions Middle Eastern women with AF have worse baseline clinical and risk score profiles compared with men. In disagreement with other regional studies, the majority of these women received guideline-recommended OACs. FUNDunding Acknowledgement Type of funding sources: None.

Abstract 154: Adherence to Rivaroxaban Compared to Other Oral Anticoagulant Agents Among Patients With Non-Valvular Atrial Fibrillation

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Colleen A McHorney ◽  
Veronica Ashton ◽  
François Laliberté ◽  
Guillaume Germain ◽  
Willy Wynant ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Patient Outcomes ◽  
Real World ◽  
Oral Anticoagulant ◽  
Index Date ◽  
Absolute Difference ◽  
Real World Data ◽  
Anticoagulant Agents ◽  
Proportion Of Days Covered ◽  
Adherence To Therapy

Background: Adherence to oral anticoagulant (OAC) agents is important for patients with non-valvular atrial fibrillation (NVAF) to prevent potentially severe adverse events. Objectives: To compare real-world adherence rates for rivaroxaban vs other oral anticoagulant agents (apixaban, dabigatran, and warfarin) among patients with NVAF using claims-based data. Methods: Healthcare claims from the IMS Health Real-World Data Adjudicated Claims database (01/2011-06/2015) were used to assess 6 month adherence rates defined as the percentage of patients with proportion of days covered (PDC) ≥0.8 and ≥0.9. Patients were included if they had ≥2 dispensings of rivaroxaban, apixaban, dabigatran, or warfarin at least 180 days apart (the first was termed as the index date), had > 60 days of supply, had ≥ 6 months of pre-index eligibility, had ≥ 1 AF diagnosis pre-index or at index date, and without valvular involvement. A logistic regression model was used to evaluate adherence to therapy adjusting for sociodemographic and clinical characteristics, insurance type, index month and year, previous OAC use, and mental-health risk factors for non-adherence (e.g., mental disorders, bipolar). Results: A total of 13,645 rivaroxaban, 6,304 apixaban, 3,360 dabigatran, and 13,366 warfarin patients were identified. A significantly higher proportion of rivaroxaban users were adherent to therapy (PDC ≥ 0.8 at 6 months vs apixaban, dabigatran, and warfarin users; Table). After adjustment, the proportion of patients adherent to therapy remained significantly higher for rivaroxaban users vs apixaban (absolute difference [AD]: 5.8%), dabigatran (AD: 9.5%), and warfarin users (AD: 13.6%; all P<0.001; Table). More pronounced differences were found with a PDC ≥0.9 (Table). Conclusion: Among NVAF patients, rivaroxaban was associated with significantly higher adherence rates relative to other OACs, whether using a PDC of ≥0.8 or ≥0.9, which could translate into improved patient outcomes and lower healthcare costs.

scholarly journals Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation

2015 ◽  
Vol 21 (2) ◽  
pp. 150-156 ◽  
Author(s):  
José Moreno-Arribas ◽  
Vicente Bertomeu-González ◽  
Manuel Anguita-Sanchez ◽  
Ángel Cequier ◽  
Javier Muñiz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Anticoagulant Agents ◽  
New Oral Anticoagulant

scholarly journals Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ayman J. Hammoudeh ◽  
Yousef Khader ◽  
Nazih Kadri ◽  
Eyas Al-Mousa ◽  
Yahya Badaineh ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Multivariate Analysis ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Middle Eastern ◽  
Outpatient Clinics ◽  
Current Status ◽  
Anticoagulant Agents ◽  
Systemic Embolization ◽  
Clinical Profiles

Background. There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines. Methods. Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline. Results. Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA2DS2-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA2DS2-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA2DS2-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA2DS2-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA2DS2-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription. Conclusions. The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.

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