Table 1.
Baseline characteristics of anticoagulant-naive patients with atrial fibrillation initiating oral anticoagulants in 2015–2016
| Characteristics (N; %*) | NOAC | VKA n=65 010 | |||
| Dabigatran n=9085 |
Rivaroxaban n=54 456 |
Apixaban n=64 300 |
Total NOAC n=1 27 841 |
||
| NOAC: reduced doses | 5652 (62.2) | 19 429 (35.7) | 26 003 (40.4) | 51 084 (40.0) | NA |
| Female sex | 4546 (50.0) | 26 147 (48.0) | 33 375 (51.9) | 64 068 (50.1) | 33 865 (52.1) |
| Age (years), mean (SD) | 74.1 (11.6) | 72.8 (11.9) | 75.3 (11.3) | 74.1 (11.6) | 78.0 (11.3) |
| 18–54 | 548 (6.0) | 4007 (7.4) | 3172 (4.9) | 7727 (6.0) | 2361 (3.6) |
| 55–64 | 1117 (12.3) | 7651 (14.0) | 7117 (11.1) | 15 885 (12.4) | 5680 (8.7) |
| 65–74 | 2514 (27.7) | 16 057 (29.5) | 16 645 (25.9) | 35 216 (27.5) | 12 969 (19.9) |
| 75–79 | 1554 (17.1) | 9053 (16.6) | 10 692 (16.6) | 21 299 (16.7) | 9587 (14.7) |
| ≥80 | 3352 (36.9) | 17 688 (32.5) | 26 674 (41.5) | 47 714 (37.3) | 34 413 (52.9) |
| ≥90 | 493 (5.4) | 2559 (4.7) | 4654 (7.2) | 7706 (6.0) | 8399 (12.9) |
| Deprivation index | |||||
| Quintile 1 (least deprived) | 1394 (15.3) | 10 265 (18.9) | 11 266 (17.5) | 22 925 (17.9) | 10 263 (15.8) |
| Quintile 2 | 1586 (17.5) | 10 678 (19.6) | 12 496 (19.4) | 24 760 (19.4) | 11 884 (18.3) |
| Quintile 3 | 1780 (19.6) | 10 701 (19.7) | 12 799 (19.9) | 25 280 (19.8) | 12 811 (19.7) |
| Quintile 4 | 1917 (21.1) | 10 794 (19.8) | 13 142 (20.4) | 25 853 (20.2) | 14 272 (22.0) |
| Quintile 5 (most deprived) | 2113 (23.3) | 11 172 (20.5) | 13 825 (21.5) | 27 110 (21.2) | 14 699 (22.6) |
| Overseas departments | 295 (3.2) | 846 (1.6) | 772 (1.2) | 1913 (1.5) | 1081 (1.7) |
| First prescriber’s specialty | |||||
| Hospital practitioner | 3720 (40.9) | 22 905 (42.1) | 29 316 (45.6) | 55 941 (43.8) | 39 083 (60.1) |
| General practitioner | 2062 (22.7) | 11 145 (20.5) | 11 590 (18.0) | 24 797 (19.4) | 15 539 (23.9) |
| Private cardiologist | 3093 (34.0) | 18 978 (34.9) | 21 843 (34.0) | 43 914 (34.4) | 8511 (13.1) |
| Private orthopaedic surgeon | 16 (0.2) | 100 (0.2) | 95 (0.1) | 211 (0.2) | 73 (0.1) |
| Other private specialist | 168 (1.8) | 1149 (2.1) | 1276 (2.0) | 2593 (2.0) | 1583 (2.4) |
| CHA2DS2-VASc score† | |||||
| Mean score (SD) | 3.7 (1.6) | 3.5 (1.6) | 3.9 (1.6) | 3.7 (1.6) | 4.5 (1.6) |
| 0 | 183 (2.0) | 1294 (2.4) | 847 (1.3) | 2324 (1.8) | 309 (0.5) |
| 1 | 635 (7.0) | 4854 (8.9) | 3637 (5.7) | 9126 (7.1) | 1607 (2.5) |
| ≥2 | 8267 (91.0) | 48 308 (88.7) | 59 816 (93.0) | 1 16 391 (90.1) | 63 094 (97.0) |
| C (heart failure) | 2849 (31.4) | 17 805 (32.7) | 23 548 (36.6) | 44 202 (34.6) | 32 727 (50.3) |
| H (antihypertensive drugs) | 7547 (83.1) | 44 260 (81.3) | 54 596 (84.9) | 106 403 (83.2) | 59 139 (91.0) |
| D(iabetes) | 1959 (21.6) | 11 279 (20.7) | 14 087 (21.9) | 27 325 (21.4) | 18 806 (28.9) |
| S(troke: ATE) | 1207 (13.3) | 4930 (9.1) | 8448 (13.1) | 14 585 (11.4) | 10 638 (16.4) |
| V(ascular diseases) | 2242 (24.7) | 13 924 (25.6) | 18 766 (29.2) | 34 932 (27.3) | 28 894 (44.4) |
| Age ≥75 and arterial thromboembolic events† | 769 (8.5) | 3126 (5.7) | 5608 (8.7) | 9503 (7.4) | 7762 (11.9) |
| Age <65 and no arterial thromboembolic events† | 1510 (16.6) | 11 074 (20.3) | 9396 (14.6) | 21 980 (17.2) | 7035 (10.8) |
| HAS-BLED score† | |||||
| Mean score (SD) | 2.0 (0.9) | 1.9 (0.9) | 2.1 (0.9) | 2.0 (0.9) | 2.7 (1.0) |
| ≥3 | 2169 (23.9) | 11 388 (20.9) | 16 834 (26.2) | 30 391 (23.8) | 36 417 (56.0) |
| A(bnormal) | |||||
| Renal function | 345 (3.8) | 2426 (4.5) | 3822 (5.9) | 6593 (5.2) | 14 260 (21.9) |
| Liver function | 169 (1.9) | 967 (1.8) | 1106 (1.7) | 2242 (1.8) | 2372 (3.6) |
| B(leeding) | |||||
| Predisposition | 182 (2.0) | 1161 (2.1) | 1605 (2.5) | 2948 (2.3) | 5873 (9.0) |
| Major bleeding | 692 (7.6) | 3729 (6.8) | 5134 (8) | 9555 (7.5) | 9348 (14.4) |
| D(rug/alcohol) | |||||
| Alcohol abuse‡ | 272 (3.0) | 1698 (3.1) | 1730 (2.7) | 3700 (2.9) | 2923 (4.5) |
| Drug–drug interactions | 947 (10.4) | 5838 (10.7) | 7570 (11.8) | 14 355 (11.2) | 23 451 (36.1) |
| Parenteral anticoagulant (heparin) | 64 (0.7) | 331 (0.6) | 361 (0.6) | 756 (0.6) | 9824 (15.1) |
| Antiplatelet drugs | 826 (9.1) | 5225 (9.6) | 6951 (10.8) | 13 002 (10.2) | 15 433 (23.7) |
| NSAIDs | 72 (0.8) | 365 (0.7) | 344 (0.5) | 781 (0.6) | 212 (0.3) |
| Other comorbidities† | |||||
| Ischaemic heart disease | 1821 (20.0) | 11 321 (20.8) | 15 439 (24.0) | 28 581 (22.4) | 23 657 (36.4) |
| Frailty (proxies) | 1666 (18.3) | 8971 (16.5) | 12 730 (19.8) | 23 367 (18.3) | 24 175 (37.2) |
| Dementia or Parkinson’s disease | 524 (5.8) | 3204 (5.9) | 4125 (6.4) | 7853 (6.1) | 7437 (11.4) |
| Psychiatric disorders | 1722 (19.0) | 10 593 (19.5) | 12 844 (20.0) | 25 159 (19.7) | 16 598 (25.5) |
| Smoking‡ | 1024 (11.3) | 6481 (11.9) | 7442 (11.6) | 14 947 (11.7) | 11 434 (17.6) |
| Comedications§ | |||||
| Antiarrhythmics or cardiac glycosides | 5996 (66.0) | 35 761 (65.7) | 41 031 (63.8) | 82 788 (64.8) | 35 600 (54.8) |
| Lipid-lowering agents | 3913 (43.1) | 22 250 (40.9) | 28 812 (44.8) | 54 975 (43.0) | 31 903 (49.1) |
| Oral corticosteroids | 1105 (12.2) | 6964 (12.8) | 8079 (12.6) | 16 148 (12.6) | 8967 (13.8) |
| Antiulcer agents | 4295 (47.3) | 24 842 (45.6) | 31 469 (48.9) | 60 606 (47.4) | 39 842 (61.3) |
| Polymedication (≥5 ATC classes) | 3750 (41.3) | 21 725 (39.9) | 28 196 (43.9) | 53 671 (42.0) | 45 153 (69.5) |
| Polymedication (≥10 ATC classes) | 738 (8.1) | 4653 (8.5) | 6246 (9.7) | 11 637 (9.1) | 14 947 (23.0) |
*Unless otherwise stated.
†Comorbidities were defined using a rolling 1-year period following the initiation of OAC therapy.
‡Smoking or alcohol data: measured by using proxies such as reimbursements for specific therapy or hospitalisations related to smoking or alcohol consumption/diseases.
§Comorbidities were defined using a rolling 4-month period preceding the initiation of OAC therapy.
ATC, Anatomical Therapeutic Chemical classification; ATE, arterial thromboembolic events (ischaemic stroke, arterial systemic embolism or transient ischaemic attack); NOAC, non-vitamin K antagonist oral anticoagulant; NSAIDs, non-steroidal anti-inflammatory drugs; VKA, vitamin K antagonist.