Persistence, effectiveness and safety of dabigatran in "real-world" Chinese patients with nonvalvular atrial fibrillation

Heart Vessels. 2020 Jul;35(7):977-984. doi: 10.1007/s00380-020-01565-5. Epub 2020 Jan 31.

Abstract

The purpose of this study is to provide detailed data on treatment persistence and clinical outcomes in Chinese patients with nonvalvular atrial fibrillation (NVAF). A single-center retrospective observational study was conducted. A total of 26,663 NVAF patients were enrolled from January 1, 2014 to December 31, 2017, clinical information of whom were from inpatient and outpatients data system was collected. The 1-year treatment persistence rates of 11,350 dabigatran users were 24.5% in 2014, 36.6% in 2015, 37.7% in 2016 and 51.8% in 2017. The predominant reason of non-persistence patients was the cost of treatment. Incidence rates of all-cause death, ischemic stroke and embolism were 1.99/100 person-years, 2.56/100 person-years and 0.77/100 person-years, respectively. Incidence rates of minor bleeding events, intracranial hemorrhage and gastrointestinal hemorrhage were 10.05/100 person-years, 0.51/100 person-years and 0.85/100 person-years, respectively. In conclusion, it is of importance for Chinese clinicians to know about these information because dabigatran is a relatively new drug in China. Compared with other reported data, patients of this study have (1) lower dabigatran persistence and lower incident rates of all-cause death, systemic embolism, minor bleeding events and gastrointestinal hemorrhage and (2) higher incident rates of ischemic stroke and intracranial hemorrhage.

Keywords: Atrial fibrillation; Bleeding events; Clinical outcomes; Dabigatran; Treatment persistence.

Publication types

  • Observational Study

MeSH terms

  • Administration, Oral
  • Aged
  • Antithrombins / administration & dosage*
  • Antithrombins / adverse effects
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / mortality
  • Brain Ischemia / diagnosis
  • Brain Ischemia / mortality*
  • Brain Ischemia / prevention & control
  • China / epidemiology
  • Dabigatran / administration & dosage*
  • Dabigatran / adverse effects
  • Embolism / diagnosis
  • Embolism / mortality
  • Embolism / prevention & control*
  • Female
  • Hemorrhage / chemically induced
  • Hemorrhage / mortality
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stroke / diagnosis
  • Stroke / mortality
  • Stroke / prevention & control*
  • Time Factors
  • Treatment Outcome

Substances

  • Antithrombins
  • Dabigatran