Epidemiology of non-vitamin K antagonist oral anticoagulants in heart disease
Atrial fibrillation and venous thromboembolism are the most common conditions requiring oral anticoagulation. Atrial fibrillation affects approximately 2% of the European population. Age, increasing common risk factors for atrial fibrillation, and earlier detection of atrial fibrillation will increase atrial fibrillation prevalence in the near future. Venous thromboembolism incidence ranges between 1 and 1.8 per 1000 person-years and is associated with substantial mortality. Oral anticoagulation with vitamin K antagonists and non-vitamin K oral anticoagulants (NOACs) has recently increased, and can help to prolong lives and enhance quality of years lived. Further, NOACs have become part of dual-pathway inhibition in patients with atherosclerotic disease, in particular after acute coronary syndrome and percutaneous coronary interventions. Whereas NOACs are not advised for anticoagulation in patients with mechanical heart valves, they are increasingly prescribed after transcatheter valve therapy.