非瓣膜性心房颤动患者的临床特征和治疗模式:阿拉伯联合酋长国迪拜的真实世界分析

Moutaz El Kadri, N. Bazargani, M. Farghaly, R. Mohamed, Nancy Awad, Ashok Natarajan, P. Pathak, Ahmed S. Ghorab, Nader El Kakoun, M. Savone, S. A. Kherraf, J. Mardekian, M. D. Fusco
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引用次数: 9

摘要

在阿拉伯联合酋长国迪拜,缺乏关于患者特征、口服抗凝血药(OAC)治疗和国际标准化比值(INR)模式的真实证据。这是一项在迪拜真实世界索赔数据库中对新诊断的成年非瓣膜性心房颤动(NVAF)患者进行的回顾性观察研究。所选患者在指标制定前12个月(基线期)内至少有一次活动索赔,并在2015年1月1日至2017年7月31日期间有一次阿哌沙班、达比加群、利伐沙班或华法林的药房索赔。排除基线期间患有瓣膜性心脏病、心脏手术、静脉血栓栓塞、短暂性心房颤动、妊娠或OAC的患者。描述了与OAC使用、指标给药、基线药物和INR模式相关的合并症和治疗模式。在5072名NVAF患者中,468人符合研究标准。其中少数(14.3%)服用华法林,最常见的非维生素K拮抗剂OACs是利伐沙班(33.3%)和阿哌沙班(31.4%),其次是达比加群(20.9%)。患者的平均年龄为59岁,平均CHA2DS2-VASc评分为2.3,最常见合并症为糖尿病、高血压、冠状动脉疾病,以及外周血管疾病。此外,51%和33%分别服用他汀类药物和阿司匹林,39%服用其他抗凝剂。大部分达比加群患者的剂量较低(57%)。INR模式显示,13%的利伐沙班、12%的阿哌沙班和7%的达比加群患者有INR要求。这项研究为阿联酋迪拜真实世界临床实践环境中OACs的使用提供了相关见解。
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Profiling Clinical Characteristics and Treatment Patterns Among Non-Valvular Atrial Fibrillation Patients: A Real-World Analysis in Dubai, United Arab Emirates
There is a dearth of real-world evidence regarding patient characteristics, Oral Anti-Coagulant (OAC) treatment, and International Normalized Ratio (INR) patterns in Dubai, United Arab Emirates (UAE). This was a retrospective observational study among newly diagnosed adult Non-valvular Atrial Fibrillation (NVAF) patients in the Dubai Real World Claims Database. Selected patients had at least one activity claim during the 12 months pre-index date (baseline period), and a pharmacy claim for apixaban, dabigatran, rivaroxaban, or warfarin from 01 JAN 2015-31 JUL 2017. Patients with valvular heart disease, cardiac surgery, venous thromboembolism, transient atrial fibrillation, pregnancy, or OAC claims during baseline were excluded. Comorbidities and treatment patterns related to OAC use, index dosing, baseline medications, and INR patterns were described. Among 5,072 NVAF patients, 468 met the study criteria. A minority of them (14.3%) were prescribed warfarin, and the most frequently prescribed non-vitamin K antagonist OACs (NOACs) were rivaroxaban (33.3%) and apixaban (31.4%), followed by dabigatran (20.9%). Patients’ mean age was 59 years and mean CHA2DS2-VASc score was 2.3, with most frequent comorbidities of diabetes mellitus, hypertension, coronary artery disease, and peripheral vascular disease. Additionally, 51% and 33% were on statins and aspirin, respectively, while 39% were on other anticoagulant agents. A large proportion of dabigatran patients were on a lower dose (57%). INR patterns revealed 13% of rivaroxaban, 12% of apixaban, and 7% of dabigatran patients had INR claims. This study provides relevant insights into the use of OACs in real-world clinical practice settings in Dubai, UAE.
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