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. 2019 Jan-Dec:25:1076029619826260.
doi: 10.1177/1076029619826260.

Utilization of Anticoagulants in Nonvalvular Atrial Fibrillation Before and After Catheter Ablation at Shanghai, China

Chen Tingting  1 , Wang Yuzhu  1 , Zhang Lin  1 , Li Ran  1 , Li Jing  1 , Wu Yi  1 , Li Xiaoyu  1 , Lv Qianzhou  1
Affiliations

Utilization of Anticoagulants in Nonvalvular Atrial Fibrillation Before and After Catheter Ablation at Shanghai, China

Chen Tingting et al. Clin Appl Thromb Hemost. 2019 Jan-Dec.

Abstract

Both vitamin K antagonists (VKAs) and novel oral anticoagulants (NOACs) are effective for stroke prevention in nonvalvular atrial fibrillation (NVAF) patients. This study evaluated the utilization of VKA and NOACs in NVAF patients before and after catheter ablation in China. Prescription data were retrospectively collected between January 1, 2016, and December 31, 2016, including indication of use, dose, renal function, and risk assessment (CHA2DS2-VASc score and HAS-BLED score) in Zhongshan Hospital of Fudan University. Trends and factors associated with anticoagulants use before and after ablation were evaluated. A total of 475 patients with NVAF who received ablation were included in the analysis. Of all, 53.26% of them received antithrombotic therapy preablation. Warfarin was prescribed in 35.26%, with NOACs in 11.37%. Four hundred seventy-three patients received antithrombotic therapy (99.58%) postablation, 236 patients with NOACs (49.68%). CHA2DS2-VASc score, HAS-BLED score, hypertension, diabetes mellitus, and alcohol were independently associated with anticoagulant utilization before catheter ablation. The higher CHA2DS2-VASc score was associated with less frequent prescription of NOACs postablation. The preablation anticoagulation use was still inadequate in China, and CHA2DS2-VASc score was a significant factor influencing the preablation anticoagulant utilization. The utilization rate of NOACs increased significantly postablation, especially for dabigatran, which implied that more physicians prefer to prescribe NOACs for NVAF patients after ablation in our country and may be attributed to the aspects such as ease of NOAC use but also possibly the greater safety and efficacy. Furthermore, the physicians may reluctant to use NOACs for high stroke risk atrial fibrillation patients after catheter ablation.

Keywords: anticoagulant utilization; atrial fibrillation; novel oral anticoagulant; warfarin.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Antithrombotic prescriptions before catheter ablation described according to age.aThe patients with no antithrombotic therapy.b The patients received warfarin or novel oral anticoagulants. cThe patients received aspirin, 0.1 mg once daily.
Figure 2.
Figure 2.
Variation of antithrombotic therapy prescriptions before and after ablation. NOACs indicates novel oral anticoagulants.
See this image and copyright information in PMC

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