Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study
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info:eu-repo/semantics/openAccessAttribution-NoDerivatives 4.0 Internationalhttps://creativecommons.org/licenses/by-nd/4.0/Tarih
2016Yazar
Başaran, ÖzcanDoğan, Volkan
Beton, Osman
Tekinalp, Mehmet
Aykan, Ahmet Cağrı
Kalaycıoğlu, Ezgi
Bolat, İsmail
Taşar, Onur
Şafak, Özgen
Kalcık, Macit
Yaman, Mehmet
İnci, Sinan
Altıntaş, Bernas
Kalkan, Sedat
Kırma, Cevat
Biteker, Murat
Karadeniz Özpamuk, Fatma
Tekkesin, Ahmet İlker
Çakıllı, Yasin
Türkkan, Ceyhan
Hamidi, Mehmet
Demir, Vahit
Gürsoy, Mustafa Ozan
Öztürk Tek, Müjgan
Aksan, Gökhan
Seyis, Sabri
Ballı, Mehmet
Alıcı, Mehmet Hayri
Bozyel, Serdar
Altun, İbrahim
Çalık, Feyza
Karaca, Oğuz
Helvacı, Füsun
Akay, Kadriye
Canga, Yiğit
Çelebi, Savaş
Altuntaş, Emine
Aytürk, Mehmet
Güneş, Hacı Murat
Bezgin, Tahir
Aksakal, Aytekin
Çakal, Beytullah
Çolak, Ayşe
Kaplan, Özgür
Tatlısu, Adem
Gözübüyük, Gökhan
Demirelli, Selami
Kaya, Adnan
Rencuzoğullari, İbrahim
Bayram, Zübeyde
Şimsek, Zeki
Civan, Murat
Batgharel, Ulaankhu
Ata, Ali Ekber
Göl, Gökhan
Mert, Gurbet Özge
Mert, Kadir Uğur
Değirmencioğlu, Aleks
Candan, Özkan
Çelebi, Özlem Özcan
Doğan, Cem
Yavuz, Fethi
Ulucan, Şeref
Arısoy, Arif
Şahin, Bingül Dilekçi
Ermiş, Emrah
Gökaslan, Serkan
Pektaş, İdris
Tanındı, Aslı
Tekin, Kamuran
Sancar Memiç, Kadriye
Çekic, Edip Güvenç
Başaran, Nesrin Filiz
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Tüm öğe kaydını gösterKünye
Başaran, Ö., Doğan, V., Beton, O., Tekinalp, M., Aykan, A. Ç., Kalaycıoğlu, E. ... Başaran, N. F. (2016). Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study. Medicine, 95(35). https://dx.doi.org/10.1097/MD.0000000000004672Özet
This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance 50mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of 3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients.
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MedicineCilt
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