TABLE 1.
Baseline characteristics of OAC-naïve AF patients.
| Patient characteristics | VKA (n = 61,406) | NOAC | SMD* | |||||
|---|---|---|---|---|---|---|---|---|
| Overall (n = 193,072) | Dabigatran (n = 28,144) | Rivaroxaban (n = 74,421) | Apixaban (n = 66,925) | Edoxaban (n = 23,582) | Before IPTW | After IPTW | ||
| Age (years) | 70.9±12.1 | 76.3±10.1 | 76.0±9.8 | 75.6±10.4 | 77.3±9.8 | 75.9±10.3 | 0.48 | 0.016 |
| <65 years | 21,158 (34.5%) | 24,741 (12.8%) | 3,632 (12.9%) | 10,841 (14.6%) | 6,940 (10.4%) | 3,328 (14.1%) | NA | NA |
| 65–74 years | 15,128 (24.6%) | 55,706 (28.9%) | 8,337 (29.6%) | 21,695 (29.2%) | 18,462 (27.6%) | 7,212 (30.6%) | ||
| 75–84 years | 16,798 (27.4%) | 72,517 (37.6%) | 10,891 (38.7%) | 27,754 (37.3%) | 25,614 (38.3%) | 8,258 (35.0%) | ||
| ≥85 years | 8,322 (13.6%) | 40,108 (20.8%) | 5,284 (18.8%) | 14,131 (19.0%) | 15,909 (23.8%) | 4,784 (20.3%) | ||
| Female | 28,766 (46.8%) | 92,008 (47.7%) | 13,130 (46.7%) | 35,188 (47.3%) | 32,892 (49.1%) | 10,798 (45.8%) | 0.016 | 0.006 |
| Reduced dose | 0 (0.0%) | 71,842 (37.2%) | 15,482 (55.0%) | 29,718 (39.9%) | 19,664 (29.4%) | 6,978 (29.6%) | NA | NA |
| Follow-up (years) | 0.8±1.3 | 1.4±1.5 | 1.6±1.7 | 1.6±1.6 | 1.4±1.3 | 0.7±0.6 | NA | NA |
| Comorbidities | ||||||||
| Hypertension | 36,945 (60.2%) | 127,931 (66.3%) | 18,382 (65.3%) | 47,785 (64.2%) | 46,477 (69.4%) | 15,287 (64.8%) | 0.127 | 0.01 |
| Coronary artery disease | 14,142 (23.0%) | 33,701 (17.5%) | 4,314 (15.3%) | 12,263 (16.5%) | 12,928 (19.3%) | 4,196 (17.8%) | 0.137 | 0.013 |
| Congestive heart failure | 9,779 (15.9%) | 30,114 (15.6%) | 3,581 (12.7%) | 10,841 (14.6%) | 12,097 (18.1%) | 3,595 (15.2%) | 0.007 | 0.023 |
| Valvular heart disease | 11,889 (19.4%) | 24,273 (12.6%) | 3,109 (11.0%) | 8,145 (10.9%) | 9,673 (14.5%) | 3,346 (14.2%) | 0.191 | 0.002 |
| Peripheral artery disease | 6,866 (11.2%) | 14,070 (7.3%) | 1866 (6.6%) | 4,865 (6.5%) | 5,757 (8.6%) | 1,582 (6.7%) | 0.126 | 0.004 |
| Dyslipidemia | 34,288 (55.8%) | 109,627 (56.8%) | 16,333 (58.0%) | 40,510 (54.4%) | 39,373 (58.8%) | 13,411 (56.9%) | 0.019 | 0.003 |
| Chronic kidney disease | 8,607 (14.0%) | 20,888 (10.8%) | 1861 (6.6%) | 6,869 (9.2%) | 9,284 (13.9%) | 2,873 (12.2%) | 0.088 | 0.008 |
| Chronic liver disease | 2,563 (4.2%) | 5,894 (3.1%) | 738 (2.6%) | 2,235 (3.0%) | 2,175 (3.3%) | 745 (3.2%) | 0.053 | 0.001 |
| Chronic lung disease | 8,428 (13.7%) | 23,618 (12.2%) | 3,039 (10.8%) | 8,928 (12.0%) | 8,854 (13.2%) | 2,796 (11.9%) | 0.037 | 0.001 |
| Obstructive sleep apnea | 2,280 (3.7%) | 6,493 (3.4%) | 879 (3.1%) | 2,481 (3.3%) | 2,279 (3.4%) | 854 (3.6%) | 0.014 | 0.012 |
| Cancer | 5,939 (9.7%) | 19,248 (10.0%) | 2,480 (8.8%) | 7,369 (9.9%) | 6,930 (10.4%) | 2,470 (10.5%) | 0.016 | 0.011 |
| Upper GI tract disorder** | 5,163 (8.4%) | 14,015 (7.3%) | 1749 (6.2%) | 5,397 (7.3%) | 5,405 (8.1%) | 1,464 (6.2%) | 0.036 | 0.008 |
| Lower GI tract disorder** | 4,175 (6.8%) | 13,482 (7.0%) | 1791 (6.4%) | 5,106 (6.9%) | 4,942 (7.4%) | 1,643 (7.0%) | 0.016 | 0.004 |
| Diabetes mellitus | 22,453 (36.6%) | 60,250 (31.2%) | 7,890 (28.0%) | 21,922 (29.5%) | 23,051 (34.4%) | 7,387 (31.3%) | 0.112 | 0.028 |
| Anemia | 6,485 (10.6%) | 14,627 (7.6%) | 1,626 (5.8%) | 5,281 (7.1%) | 5,975 (8.9%) | 1745 (7.4%) | 0.094 | 0.004 |
| Dementia | 2,809 (4.6%) | 10,753 (5.6%) | 1,297 (4.6%) | 4,046 (5.4%) | 4,312 (6.4%) | 1,098 (4.7%) | 0.051 | 0.018 |
| History of falling | 4,003 (6.5%) | 16,170 (8.4%) | 1817 (6.5%) | 5,290 (7.1%) | 6,930 (10.4%) | 2,134 (9.0%) | 0.08 | 0.035 |
| Frailty | 13,746 (22.4%) | 58,738 (30.4%) | 7,735 (27.5%) | 20,840 (28.0%) | 23,623 (35.3%) | 6,540 (27.7%) | 0.187 | 0.024 |
| Prior stroke/SE | 8,759 (14.3%) | 26,635 (13.8%) | 4,875 (17.3%) | 7,815 (10.5%) | 11,697 (17.5%) | 2,249 (9.5%) | 0.004 | 0.013 |
| Prior MB/CRNMB | 4,008 (6.5%) | 10,270 (5.3%) | 1,379 (4.9%) | 3,569 (4.8%) | 4,153 (6.2%) | 1,170 (5.0%) | 0.04 | 0.005 |
| Medication history | ||||||||
| Number of concomitant drugs | 6.8±4.5 | 6.6±4.1 | 6.3±3.8 | 6.5±4.1 | 7.0±4.3 | 6.4±4.0 | 0.049 | 0.004 |
| Beta blockers | 31,820 (51.8%) | 119,997 (62.2%) | 17,201 (61.1%) | 44,678 (60.0%) | 43,133 (64.4%) | 14,985 (63.5%) | 0.21 | 0.008 |
| Verapamil, diltiazem | 2,162 (3.5%) | 7,741 (4.0%) | 1,147 (4.1%) | 3,192 (4.3%) | 2,627 (3.9%) | 775 (3.3%) | 0.026 | 0.017 |
| Digoxin | 3,694 (6.0%) | 18,837 (9.8%) | 2,564 (9.1%) | 6,934 (9.3%) | 7,111 (10.6%) | 2,228 (9.4%) | 0.139 | 0.011 |
| Class I AAD | 3,490 (5.7%) | 19,811 (10.3%) | 3,068 (10.9%) | 8,196 (11.0%) | 6,024 (9.0%) | 2,523 (10.7%) | 0.17 | 0.007 |
| Class III AAD | 11,578 (18.9%) | 49,873 (25.8%) | 7,242 (25.7%) | 20,148 (27.1%) | 17,217 (25.7%) | 5,266 (22.3%) | 0.168 | 0.027 |
| Acetylsalicylic acid | 21,648 (35.3%) | 78,333 (40.6%) | 11,430 (40.6%) | 29,564 (39.7%) | 28,060 (41.9%) | 9,279 (39.3%) | 0.11 | 0.007 |
| P2Y12 inhibitor | 3,391 (5.5%) | 11,290 (5.8%) | 1,495 (5.3%) | 3,869 (5.2%) | 4,233 (6.3%) | 1,693 (7.2%) | 0.014 | 0.011 |
| Proton pump inhibitor | 25,707 (41.9%) | 76,541 (39.6%) | 10,448 (37.1%) | 28,919 (38.9%) | 27,865 (41.6%) | 9,309 (39.5%) | 0.045 | 0.016 |
| NSAID | 16,501 (26.9%) | 46,481 (24.1%) | 6,856 (24.4%) | 18,565 (24.9%) | 15,513 (23.2%) | 5,547 (23.5%) | 0.064 | 0.005 |
| Oral corticosteroids | 13,892 (22.6%) | 38,247 (19.8%) | 5,109 (18.2%) | 15,002 (20.2%) | 13,507 (20.2%) | 4,629 (19.6%) | 0.069 | 0.001 |
| SSRI/SNRI | 8,233 (13.4%) | 23,094 (12.0%) | 3,283 (11.7%) | 9,148 (12.3%) | 8,336 (12.5%) | 2,327 (9.9%) | 0.043 | 0.014 |
| Clinical risk score | ||||||||
| CHA2DS2-VASc score | 3.2±2.0 | 3.6±1.8 | 3.5±1.7 | 3.4±1.7 | 3.8±1.8 | 3.4±1.7 | 0.183 | 0.015 |
| HAS-BLED score | 2.3±1.4 | 2.5±1.2 | 2.5±1.2 | 2.4±1.2 | 2.7±1.2 | 2.5±1.2 | 0.184 | 0.011 |
| Charlson Comorbidity Index | 4.0±2.5 | 4.4±2.2 | 4.3±2.1 | 4.3±2.2 | 4.7±2.2 | 4.3±2.2 | 0.183 | 0.006 |
Data shown as mean ± standard deviation, or counts and percentages. VKA users included 29,650 acenocoumarol, 16,859 warfarin and 14,897 phenprocoumon users.
a
Absolute SMDs, illustrated for comparison of NOACs, versus VKAs, before and after inverse probability of treatment weighting.
b
Upper and lower gastrointestinal tract disorders were defined as gastroesophageal reflux disease or peptic ulcer disease; and diverticulosis, angiodysplasia, colorectal polyposis or hemorrhoids, respectively. AAD: antiarrhythmic drug; AF: atrial fibrillation; CRNMB: clinically relevant non-major bleeding; GI: gastrointestinal; MB: major bleeding; NA: not applicable; NOAC: non-vitamin K antagonist oral anticoagulant; NSAID: non-steroidal anti-inflammatory drug; OAC: oral anticoagulant; SE: systemic embolism; SMD: standardized mean difference; SNRI: serotonin and norepinephrine reuptake inhibitor; SSRI: selective serotonin reuptake inhibitor; VKA: vitamin K antagonist.