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Updated: Mar 15, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

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Antithrombotic Usage Patterns in the Era of New Oral Anticoagulant Options for Atrial Fibrillation

Jacob Marler, Justin B Usery, Shambria Nolan

    Hospital Pharmacy
    |August 26, 2016
    PubMed

    Insights

    The introduction of new anticoagulants did not increase prescribing rates for non-valvular atrial fibrillation (NVAF) patients. Anticoagulant use remains suboptimal despite expanded treatment options for stroke prevention.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Public Health

    Background:

    • Stroke risk is reduced with appropriate treatment in atrial fibrillation (AF) patients.
    • Warfarin prescribing rates are inadequate in high-risk AF patients.
    • Novel oral anticoagulants (NOACs) offer tailored therapy options for non-valvular AF (NVAF).

    Purpose of the Study:

    • To evaluate the impact of dabigatran and rivaroxaban availability on anticoagulant prescribing rates at hospital discharge for NVAF patients.
    • To compare anticoagulant prescribing trends before and after the introduction of NOACs.

    Main Methods:

    • Retrospective chart review of NVAF patients (CHADS2 score ≥2).
    • Comparison of patient data from 2009 (pre-NOAC availability) and 2012 (post-NOAC availability).
    • Review of antithrombotic therapy, major bleeding, and stroke events within one year post-discharge.

    Main Results:

    • Anticoagulant prescribing rates were 68.3% in 2009 and 77.1% in 2012 (p = .16).
    • In 2012, warfarin was prescribed to 64% of patients, dabigatran to 28%, and rivaroxaban to 8%.
    • Major bleeding rates were 1.2% in 2009 and 4.4% in 2012 (p = .4).

    Conclusions:

    • No statistically significant difference in anticoagulant prescribing rates was observed between 2009 and 2012.
    • Anticoagulant prescribing rates remain suboptimal in high-risk NVAF patients despite increased treatment options.
    • Further strategies are needed to improve anticoagulation for stroke prevention in NVAF.
    Abstract

    Keywords:
    atrial fibrillationdabigatranrivaroxabanstroke prophylaxiswarfarin

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