Table 1.
Baseline characteristics of the cohort of 30 467 new users of NOACs with NVAF and no other recent indication, stratified by dose of first NOAC prescription (standard or reduced dose)
| Apixaban (n=10 834) | Dabigatran (n=4381) | Rivaroxaban (n=15 252)* | ||||
| Standard dose (n=7061; 65.2%) |
Reduced dose (n=3773; 34.8%) |
Standard dose (n=2018; 46.1%) |
Reduced dose (n=2363; 53.9%) |
Standard dose (n=12 091; 79.3%) |
Reduced dose (n=3081; 20.2%) |
|
| Sex | ||||||
| Male | 4271 (60.5) | 1488 (39.4) | 1380 (68.4) | 1143 (48.4) | 7042 (58.2) | 1289 (41.8) |
| Female | 2790 (39.5) | 2285 (60.6) | 638 (31.6) | 1220 (51.6) | 5049 (41.8) | 1792 (58.2) |
| Age (years) | ||||||
| <60 | 833 (11.8) | 63 (1.7) | 380 (18.8) | 73 (3.1) | 1233 (10.2) | 66 (2.1) |
| 60–69 | 1903 (27.0) | 177 (4.7) | 726 (36.0) | 202 (8.5) | 2696 (22.3) | 199 (6.5) |
| 70–79 | 2860 (40.5) | 676 (17.9) | 842 (41.7) | 699 (29.6) | 4400 (36.4) | 715 (23.2) |
| ≥80 | 1465 (20.7) | 2857 (75.7) | 70 (3.5) | 1389 (58.8) | 3762 (31.1) | 2101 (68.2) |
| Mean age (SD) | 71.4 (10.2) | 82.8 (7.8) | 67.2 (9.1) | 79.7 (8.5) | 73.6 (10.6) | 81.8 (8.5) |
| OAC naïve status | ||||||
| Naïve | 3915 (55.4) | 1859 (49.3) | 909 (45.0) | 918 (38.8) | 5881 (48.6) | 1295 (42.0) |
| Non-naïve | 3146 (44.6) | 1914 (50.7) | 1109 (55.0) | 1445 (61.2) | 6210 (51.4) | 1786 (58.0) |
| Year of first NOAC prescription | ||||||
| 2011–2013 | 184 (2.6) | 107 (2.8) | 968 (48.0) | 1206 (51.0) | 1492 (12.3) | 479 (15.5) |
| 2014–2016 | 6877 (97.4) | 3666 (97.2) | 1050 (52.0) | 1157 (49.0) | 10 599 (87.7) | 2602 (84.5) |
| BMI | ||||||
| 10–19 (underweight) | 117 (1.7) | 331 (8.8) | 35 (1.7) | 139 (5.9) | 434 (3.6) | 212 (6.9) |
| 20–24 (healthy weight) | 1322 (18.7) | 1201 (31.8) | 343 (17.0) | 665 (28.1) | 2679 (22.2) | 875 (28.4) |
| 25–29 (overweight) | 2599 (36.8) | 1228 (32.5) | 735 (36.4) | 866 (36.6) | 4230 (35.0) | 1035 (33.6) |
| ≥30 (obese) | 2766 (39.2) | 836 (22.2) | 809 (40.1) | 593 (25.1) | 4291 (35.5) | 847 (27.5) |
| Unknown | 257 (3.6) | 177 (4.7) | 96 (4.8) | 100 (4.2) | 457 (3.8) | 112 (3.6) |
| Smoking | ||||||
| Non-smoker | 2851 (40.4) | 1683 (44.6) | 784 (38.9) | 1015 (43.0) | 4876 (40.3) | 1282 (41.6) |
| Smoker | 605 (8.6) | 221 (5.9) | 178 (8.8) | 126 (5.3) | 1015 (8.4) | 182 (5.9) |
| Ex-smoker | 3598 (51.0) | 1865 (49.4) | 1052 (52.1) | 1221 (51.7) | 6190 (51.2) | 1617 (52.5) |
| Unknown | 7 (0.1) | 4 (0.1) | 4 (0.2) | 1 (0.0) | 10 (0.1) | 0 (0.0) |
| Alcohol (units/week) | ||||||
| None | 1356 (19.2) | 1129 (29.9) | 244 (12.1) | 526 (22.3) | 2244 (18.6) | 827 (26.8) |
| 1–9 | 3044 (43.1) | 1663 (44.1) | 857 (42.5) | 1128 (47.7) | 5501 (45.5) | 1448 (47.0) |
| 10–20 | 1316 (18.6) | 390 (10.3) | 422 (20.9) | 315 (13.3) | 1975 (16.3) | 316 (10.3) |
| 21–41 | 470 (6.7) | 128 (3.4) | 219 (10.9) | 99 (4.2) | 821 (6.8) | 95 (3.1) |
| ≥42 | 227 (3.2) | 48 (1.3) | 92 (4.6) | 45 (1.9) | 354 (2.9) | 50 (1.6) |
| Unknown | 648 (9.2) | 415 (11.0) | 184 (9.1) | 250 (10.6) | 1196 (9.9) | 345 (11.2) |
| History of CVD | ||||||
| IHD | 1939 (27.5) | 1309 (34.7) | 416 (20.6) | 735 (31.1) | 3014 (24.9) | 1098 (35.6) |
| Heart failure | 1080 (15.3) | 847 (22.4) | 268 (13.3) | 469 (19.8) | 1709 (14.1) | 791 (25.7) |
| Hypertension | 4464 (63.2) | 2762 (73.2) | 1192 (59.1) | 1691 (71.6) | 7888 (65.2) | 2338 (75.9) |
| Ischaemic stroke | 990 (14.0) | 774 (20.5) | 254 (12.6) | 435 (18.4) | 1567 (13.0) | 553 (17.9) |
| History of bleeding disorders | ||||||
| Intracranial bleeding | 96 (1.4) | 108 (2.9) | 20 (1.0) | 51 (2.2) | 139 (1.1) | 52 (1.7) |
| GI bleeding | 957 (13.6) | 573 (15.2) | 232 (11.5) | 349 (14.8) | 1609 (13.3) | 440 (14.3) |
| Urogenital bleeding | 877 (12.4) | 517 (13.7) | 214 (10.6) | 309 (13.1) | 1629 (13.5) | 449 (14.6) |
| eGFR (CKD-EPI) /min/1.73 m2 | ||||||
| >50 | 5323 (75.4) | 1968 (52.2) | 1625 (80.5) | 1634 (69.1) | 9547 (79.0) | 1105 (35.9) |
| 30–50 | 694 (9.8) | 1125 (29.8) | 110 (5.5) | 464 (19.6) | 892 (7.4) | 1475 (47.9) |
| <30 | 25 (0.4) | 255 (6.8) | 4 (0.2) | 16 (0.7) | 46 (0.4) | 223 (7.2) |
| Unknown | 1019 (14.4) | 425 (11.3) | 279 (13.8) | 249 (10.5) | 1606 (13.3) | 278 (9.0) |
| Frailty index | ||||||
| Fit | 1306 (18.5) | 191 (5.1) | 517 (25.6) | 201 (8.5) | 2120 (17.5) | 133 (4.3) |
| Mild frailty | 2839 (40.2) | 933 (24.7) | 918 (45.5) | 706 (29.9) | 4624 (38.2) | 668 (21.7) |
| Moderate frailty | 1978 (28.0) | 1395 (37.0) | 448 (22.2) | 833 (35.3) | 3522 (29.1) | 1182 (38.4) |
| Severe frailty | 938 (13.3) | 1254 (33.2) | 135 (6.7) | 623 (26.4) | 1825 (15.1) | 1098 (35.6) |
| CHA2DS2VASc score | ||||||
| 0 | 42 (6.0) | 25 (0.7) | 220 (10.9) | 32 (1.4) | 608 (5.0) | 23 (0.7) |
| 1 | 675 (9.6) | 52 (1.4) | 260 (12.9) | 76 (3.2) | 1107 (9.2) | 68 (2.2) |
| 2 | 1425 (20.2) | 252 (6.7) | 517 (25.6) | 222 (9.4) | 2182 (18.0) | 199 (6.5) |
| 3 | 1564 (22.1) | 623 (16.5) | 418 (20.7) | 475 (20.1) | 2681 (22.2) | 507 (16.5) |
| ≥4 | 2971 (42.1) | 2821 (74.8) | 603 (29.9) | 1558 (65.9) | 5513 (45.6) | 2284 (74.1) |
| Mean (SD) | 3.2 (1.8) | 4.6 (1.6) | 2.7 (1.7) | 4.2 (1.7) | 3.4 (1.8) | 4.6 (1.6) |
| CHADS score | ||||||
| 0 | 1127 (16.0) | 103 (2.7) | 480 (23.8) | 114 (4.8) | 1696 (14.0) | 103 (3.3) |
| 1 | 2119 (30.0) | 595 (15.8) | 681 (33.7) | 448 (19.0) | 3440 (28.5) | 452 (14.7) |
| 2 | 1929 (27.3) | 1259 (33.4) | 468 (23.2) | 786 (33.3) | 3596 (29.7) | 1044 (33.9) |
| ≥3 | 1886 (26.7) | 1816 (48.1) | 389 (19.3) | 1015 (43.0) | 3359 (27.8) | 1482 (48.1) |
| Mean (SD) | 1.8 (1.3) | 2.6 (1.3) | 1.5 (1.2) | 1.9 (1.3) | 1.9 (1.3) | 2.6 (1.3) |
| HAS-BLED score | ||||||
| 0 | 814 (11.5) | 46 (1.2) | 312 (15.5) | 49 (2.1) | 1224 (10.1) | 54 (1.8) |
| 1 | 2437 (34.5) | 1163 (30.8) | 704 (34.9) | 721 (30.5) | 4460 (36.9) | 938 (30.4) |
| 2 | 2510 (35.5) | 1514 (40.1) | 699 (34.6) | 1005 (42.5) | 4467 (36.9) | 1305 (42.4) |
| 3 | 1089 (15.4) | 789 (20.9) | 263 (13.0) | 470 (19.9) | 1612 (13.3) | 596 (19.3) |
| ≥4 | 211 (3.0) | 261 (6.9) | 40 (2.0) | 118 (5.0) | 328 (2.7) | 188 (6.1) |
| Mean (SD) | 1.6 (1.0) | 2.0 (1.0) | 1.6 (0.9) | 2.0 (0.9) | 1.6 (0.9) | 2.0 (0.9) |
| Medications† | ||||||
| Antiplatelets | 3250 (46.0) | 1844 (48.9) | 993 (49.2) | 1285 (54.4) | 5299 (43.8) | 1519 (49.3) |
| Antiarrhythmics | 1074 (15.2) | 467 (12.4) | 403 (20.0) | 425 (18.0) | 1764 (14.6) | 403 (13.1) |
| Antihypertensives | 6114 (86.6) | 3400 (90.1) | 1743 (86.4) | 2147 (90.9) | 10 591 (87.6) | 2860 (92.8) |
*80 patients starting therapy on rivaroxaban were prescribed an initial daily dose higher than standard daily dose (>20 mg/day) and are not included in the table.
†Prescription in the year before the first NOAC prescription.
BMI, body mass index; CKD-EPI, chronic kidney disease epidemiology; CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; GI, gastrointestinal; IHD, ischaemic heart disease; NOACs, non-vitamin K antagonist oral anticoagulants; NVAF, non-valvular atrial fibrillation.