Related Experiment Video

Updated: Jan 27, 2026

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats
05:12

Transesophageal Atrial Burst Pacing for Atrial Fibrillation Induction in Rats

Published on: February 14, 2022

3.8K

Changes in Oral Anticoagulation Therapy over One Year in 51,000 Atrial Fibrillation Patients at Risk for Stroke: A

Stefan H Hohnloser1, Edin Basic2, Michael Nabauer3

  • 1Division of Clinical Electrophysiology, Department of Cardiology, Johann Wolfgang Goethe University, Frankfurt, Germany.

Thrombosis and Haemostasis
|March 23, 2019
PubMed

Insights

Discontinuation rates for vitamin K antagonists (VKA) and non-vitamin K oral anticoagulants (NOACs) are similar in atrial fibrillation patients after one year. Switching from VKA to NOAC is more frequent than the reverse, often linked to clinical events.

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Atrial fibrillation (AF) management requires effective anticoagulation therapy.
  • Non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) are primary treatment options.
  • Understanding treatment changes is crucial for optimizing patient care.

Purpose of the Study:

  • To assess temporal changes in anticoagulation therapy among patients with atrial fibrillation (AF).
  • To evaluate discontinuation and switching patterns between NOACs and VKAs.
  • To identify predictors of treatment modifications in AF patients.

Main Methods:

  • Analysis of a large claims-based dataset (4 million individuals).
  • Inclusion of AF patients initiating NOACs or VKAs between 2013-2016.
  • Use of Cox proportional hazards regression to determine predictors of treatment changes.

Main Results:

  • Comparable 1-year discontinuation rates for VKA (29.9%) and NOACs (29.5%).
  • Higher switching from VKA to NOAC (10.7%) compared to NOAC to VKA (4.9%).
  • Treatment changes, particularly among NOAC users, were associated with stroke, myocardial infarction, and gastrointestinal bleeding.

Conclusions:

  • VKA and NOAC discontinuation rates are similar within the first year of AF treatment.
  • Switching from VKA to NOAC is more prevalent than the reverse.
  • Clinical events significantly influence anticoagulation treatment modifications in AF patients.
Abstract

More Related Videos

Robotic Ablation of Atrial Fibrillation11:21

Robotic Ablation of Atrial Fibrillation

Published on: May 29, 2015

20.2K
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

2.1K

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.2K
Amyloid Fibrils03:03

Amyloid Fibrils

Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
Amyloid deposits were observed as early as 1639 in the liver and the spleen.   In 1854, Rudolph Virchow performed iodine staining,...
11.8K
Amyloid Fibrils03:03

Amyloid Fibrils

6.4K
Fibril-associated Collagen01:11

Fibril-associated Collagen

Fibril-associated collagens are a type of collagens present in the extracellular matrix with interrupted triple helices or FACIT (Fibril-associated collagens interrupted triple-helices). FACIT help connect and attach the collagen fibrils with each other as well as with other proteins of the extracellular matrix.
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
3.3K
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
1.8K
Relative Risk01:12

Relative Risk

Relative risk (RR) is a statistical measure commonly used in epidemiology to compare the likelihood of a particular event occurring between two groups. This metric is important for evaluating the relationship between exposure to a specific risk factor and the probability of a particular outcome. It plays a crucial role in medical research, public health studies, and risk assessment. Relative risk quantifies how much more (or less) likely an event is to occur in an exposed group compared to an...
2.1K