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001-es BibID:	BIBFORM111209
035-os BibID:	(scopus)85151758723
Első szerző:	Papp Tímea Bianka (általános orvos)
Cím:	Mortality on DOACs Versus on Vitamin K Antagonists in Atrial Fibrillation : Analysis of the Hungarian Health Insurance Fund Database / Papp Tímea Bianka, Kiss Zoltán, Rokszin György, Fábián Ibolya, Márk László, Bagoly Zsuzsa, Becker Dávid, Merkely Béla, Aradi Dániel, Dézsi Csaba András, Járai Zoltán, Csanádi Zoltán
Dátum:	2023
ISSN:	0149-2918
Megjegyzések:	Purpose: Limited real-world data are available on the survival of patients treated with vitamin K antagonists (VKAs) versus with direct oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). In this nationwide registry, we analyzed the mortality risk of patients with nonvalvular AF taking DOACs versus. VKAs, with a special attention to the early treatment period. Methods: The Hungarian National Health Insurance Fund (NHIF) database was searched to identify patients treated with VKA or DOAC as a thromboembolic prophylaxis for nonvalvular AF between 2011 and 2016. The overall and the early (0-3, 4-6, 7-12 months) mortality risks with the 2 types of anticoagulation were compared. A total of 144,394 patients with AF treated with either a VKA (n = 129,925) or a DOAC (n = 14,469) were enrolled. Findings: A 28% improvement in 3-year survival with DOAC treatment compared with VKA treatment was shown. Mortality reduction with DOACs was consistent across different subgroups. However, younger patients (30-59 years old) initiated on DOAC therapy had the greatest RRR (53%) in mortality. Furthermore, DOAC treatment also yielded a benefit of greater magnitude (HR 0.55; 95% CI, 0.40-0.77; p=0.001) in the lower (0-1) CHA2DS2-VASc score segment and in those with fewer (0-1) bleeding risk factors (HR: 0.50; 95% CI, 0.34-0.73; p=0.001). The RRR in mortality with DOACs was 33% within the first 3 months, and 6% in the second year. Implications: Thromboembolic prophylaxis with DOACs in this study yielded significantly lower mortality compared with VKA treatment in patients with nonvalvular AF. The largest benefit was shown in the early period after treatment initiation, as well as in younger patients, those with a lower CHA2DS2-VASc score, and those with fewer bleeding risk factors.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk atrial fibrillation direct oral anticoagulant mortality risk reduction thromboembolism vitamin K antagonist
Megjelenés:	Clinical Therapeutics. - 45 : 4 (2023), p. 333-346. -
További szerzők:	Kiss Zoltán (Pécs) Rokszin György Fábián Ibolya Márk László (1956-) (belgyógyász, kardiológus) Bagoly Zsuzsa (1978-) (orvos) Becker Dávid Merkely Béla (1965-) (orvos) Aradi Dániel Dézsi Csaba András Járai Zoltán Csanádi Zoltán (1960-) (kardiológus)
Pályázati támogatás:	GINOP-2.3.2-15-2016-00043 GINOP
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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