Details

Autor(en) / Beteiligte

• Cannon, FAHA, Christopher P
• Sutherland, Julie
• Ehrlich, Clifford L
• Bachireddy, Ravinder
• Valentine, Michael
• Smiley, Nasser
• Hearne, Steven
• Trebnick, April
• Datta, Sudarshana
• Jaffer, Sara
• Tucker, Emily A
• Thorpe, Fran
• Cavender, Matthew A
• Hsieh, Wen-Hua
• Doros, Gheorghe
• O’Hare, Ali W
• Kalayci, Arzu
• Reynolds, Matthew

Titel

Abstract 14202: The Benchmarking an Oral Anticoagulant Treatment Rate in Patients With Nonvalvular Atrial Fibrillation (BOAT-AF) Study: A Prospective, Multicenter Study Evaluating Perspectives on Use of Oral Anticoagulation Using a Patient Survey and Clinical Review by the Treating Physician Among Patients Not Currently Treated With Oral Anticoagulation

Ist Teil von

• Circulation (New York, N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A14202-A14202

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2018

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• IntroductionOral anticoagulants (OA) reduce thromboembolic events in patients with non-valvular atrial fibrillation (NVAF); however, these medications are not utilized in all eligible patients. Studies examining the reasons for non-utilization are sparse.HypothesisWe hypothesized many patients would be able to be open to anticoagulationMethodsBOAT-AF (NCT02919982) was a prospective, multicenter study aimed to assess reasons for not prescribing OA. Between 1/18/2017 and 5/7/2018, 817 patients with NVAF and CHA2DS2-VASc ≥ 2, who were not currently treated with OA were enrolled from 19 sites within the American College of Cardiology’s PINNACLE Registry. A survey was completed by each patient and a clinical review was performed by their treating physician.ResultsMean age was 76 +10 years (range 33-101), with 45% women. Median CHA2DS2-Vasc score was 4 (interquartile range 3, 6) and HAS-BLED 3 (2, 3). Patients reported that 52% had previously been prescribed OA, but had stopped due to bleeding (17.8%), personal preference (9.1%), no further atrial fibrillation (AFib) (9.1%) or for some other reason (13.7%). Only 12.3% of patients were very or extremely worried about risk of stroke and 33.8% were somewhat worried, whereas 29.6% were very or extremely worried about bleeding, and an additional 26.6% were somewhat worried; however, 38.4% of patients said they “would consider taking blood thinners”. The top five reasons (not mutually exclusive) physicians cited for the patients not being on OA werelow AFib burden/successful rhythm control therapy (34.0%), patient refusal (33.3%), perceived low risk of stroke (25.2%), fall risk (21.4%), and high risk of bleeding (20.4%). Interestingly, after re-review, physicians said for 27.1% of patients they would consider prescribing OA (5.4% warfarin and 21.7% NOAC).ConclusionsIn a cohort of patients with NVAF not on OA, patients expressed greater worry about bleeding risk than stroke risk. The most common reason physicians did not prescribe OA was due to a low burden of AFib or perceived low risk of stroke. The review process in this study appears to identify a large group of patients who could be anticoagulated from both the physician and patient perspectives. Further analyses will match physician vs. patient perceptions to explore opportunities for improving management of AFib.