Direct Oral Anticoagulant Use: Complications for High-Risk Atrial Fibrillation Patients

Activity: Talk or presentation types › Poster presentation

Description

Direct oral anticoagulants (DOACs) have become an alternatives to the long-standing standard of care in anticoagulation, vitamin K antagonist. Anticoagulation is associated with clinical benefit in atrial fibrillation (AF) patients despite their elevated bleeding risk. With the expanding role of DOACs, clinicians are faced with increasingly complex decisions relating to appropriate agent and use in special clinical situations. The aim of this study was to analyze the DOACs use in patients with specific comorbidities and major drug interactions to promote effective DOAC prescribing.. Quantitative, analytic, cross-sectional clinical study during the period from December 2016 to January 2019, was performed at Pauls Stradins Clinical University Hospital, Center of Cardiology, Latvia. There were collected data about patients with AF under anticoagulative therapy ≥3 months, risk scores calculated by CHA2DS2-VASc and HAS-BLED. For quantitative measure anti-factor Xa and direct thrombin inhibitors tests were used. Data were analyzed using SPSS.. In total, 31 patients were included; 61.3% were male; the mean age was 70.68 (SD±8.34) years. The mean CHA2DS2-VASc and HAS-BLED scores was 3.9 (SD±1.99) and 1.8 (SD±0.96). The most common comorbidities were arterial hypertension (77.4%; 24), coronary artery disease (54.8%; 17) and diabetes mellitus (29.0%; 9). The mean body mass index (BMI) was 28.7 kg/m2 (SD±5.70); more than 30 kg/m2 was 8 patients, so DOAC use must be considered. 77.4% used rivaroxaban, most frequently at increased dose 20 mg (41.9%; 13). Risk of significant drug-drug interactions was evaluated with statins (61.3%; 19), proton pump inhibitors (35.48%; 11) and anti-inflammatory drugs (22.58%; 7). There were correlation between BMI and Cmax identified, higher for patients with lower BMI and vice versa (p=0.005).. DOACs have revolutionized anticoagulant management and are becoming the cornerstone treatment for stroke prevention in AF treatment. Patient comorbidities must be considered when selecting most appropriate anticoagulant and monitored routinely.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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