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Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?—Results of the Polish Atrial Fibrillation (POL-AF) Registry

Author

Listed:
  • Anna Szyszkowska

    (Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland)

  • Łukasz Kuźma

    (Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland)

  • Beata Wożakowska-Kapłon

    (1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
    Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland)

  • Iwona Gorczyca-Głowacka

    (1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
    Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland)

  • Olga Jelonek

    (1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
    Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland)

  • Beata Uziębło-Życzkowska

    (Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland)

  • Paweł Krzesiński

    (Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland)

  • Maciej Wójcik

    (Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland)

  • Robert Błaszczyk

    (Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland)

  • Monika Gawałko

    (1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
    Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, 6229 ER Maastricht, The Netherlands
    Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, 45147 Essen, Germany)

  • Agnieszka Kapłon-Cieślicka

    (1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland)

  • Tomasz Tokarek

    (Center for Invasive Cardiology, Electrotherapy and Angiology, 38-400 Nowy Sacz, Poland)

  • Renata Rajtar-Salwa

    (Cardiology and Cardiovascular Interventions Clinical Department, The University Hospital, 30-688 Krakow, Poland)

  • Jacek Bil

    (Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland)

  • Michał Wojewódzki

    (Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland)

  • Anna Szpotowicz

    (Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland)

  • Małgorzata Krzciuk

    (Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland)

  • Janusz Bednarski

    (Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland)

  • Elwira Bakuła

    (Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland)

  • Marcin Wełnicki

    (3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland)

  • Artur Mamcarz

    (3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland)

  • Anna Tomaszuk-Kazberuk

    (Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland)

Abstract

Background: The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). Methods: The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. Results: Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA 2 DS 2 -VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use—out of reduced dosage groups, p = 0.06). Conclusions: A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.

Suggested Citation

  • Anna Szyszkowska & Łukasz Kuźma & Beata Wożakowska-Kapłon & Iwona Gorczyca-Głowacka & Olga Jelonek & Beata Uziębło-Życzkowska & Paweł Krzesiński & Maciej Wójcik & Robert Błaszczyk & Monika Gawałko & A, 2022. "Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?—Results of the Polish Atrial Fibrillation (POL-AF) Registry," IJERPH, MDPI, vol. 19(19), pages 1-13, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:11939-:d:921430
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