Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study
Date
2016Author
Basaran, OzcanDogan, Volkan
Beton, Osman
Tekinalp, Mehmet
Aykan, Ahmet Cagri
Kalaycioglu, Ezgi
Bolat, Ismail
Tasar, Onur
Safak, Ozgen
Kalcik, Macit
Yaman, Mehmet
Inci, Sinan
Altintas, Bernas
Kalkan, Sedat
Kirma, Cevat
Biteker, Murat
Karadeniz, Fatma Ozpamuk
Tekkesin, Ahmet Ilker
Cakilli, Yasin
Turkkan, Ceyhan
Hamidi, Mehmet
Demir, Vahit
Gursoy, Mustafa Ozan
Ozturk, Mujgan Tek
Aksan, Gokhan
Seyis, Sabri
Balli, Mehmet
Alici, Mehmet Hayri
Bozyel, Serdar
Altun, Ibrahim
Calik, Feyza
Karaca, Oguz
Helvaci, Fusun
Akay, Kadriye
Canga, Yigit
Celebi, Savas
Altuntas, Emine
Ayturk, Mehmet
Gunes, Haci Murat
Bezgin, Tahir
Aksakal, Aytekin
Cakal, Beytullah
Colak, Ayse
Kaplan, Ozgur
Tatlisu, Adem
Gozubuyuk, Gokhan
Demirelli, Selami
Kaya, Adnan
Rencuzogullari, Ibrahim
Bayram, Zubeyde
Simsek, Zeki
Civan, Murat
Batgharel, Ulaankhu
Ata, Ali Ekber
Gol, Gokhan
Mert, Gurbet Ozge
Mert, Kadir Ugur
Degirmencioglu, Aleks
Candan, Ozkan
Celebi, Ozlem Ozcan
Dogan, Cem
Yavuz, Fethi
Ulucan, Seref
Arisoy, Arif
Sahin, Bingul Dilekci
Ermis, Emrah
Gokaslan, Serkan
Pektas, Idris
Tanindi, Asli
Tekin, Kamuran
Sancar, Kadriye Memic
Cekic, Edip Guvenc
Basaran, Nesrin Filiz
Metadata
Show full item recordAbstract
This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance 50mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of 3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients.
Source
MEDICINEVolume
95Issue
35Collections
- Makale Koleksiyonu [5200]
- Makale Koleksiyonu [5745]
- Öksüz Yayınlar Koleksiyonu - WoS [6162]
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