Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, 2900, Hellerup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen N, Denmark.
Sci Rep. 2017 Jun 13;7(1):3347. doi: 10.1038/s41598-017-03596-x.
Danish nationwide registries were used to investigate temporal trends in initiation of rivaroxaban or apixaban or dabigatran versus vitamin K antagonists (VKA) in patients with venous thromboembolism (VTE). Patients treated with one of the NOACs (rivaroxaban, dabigatran, apixaban) or VKA were identified between February 2012 and September 2016. A total of 19,578 patients were included of which 10,844 (55.4%) were treated with VKA and 8,734 (44.6%) were treated with NOACs (rivaroxaban 7,572, apixaban 1,066, and dabigatran 96). Temporal trends showed a decrease in the initiation of VKA (p-value for decreasing trend, p < 0001) and an increase in the initiation of rivaroxaban and apixaban (p-value for increasing trend, p < 0001). By September 2016, 12%, 70%, 16%, and 2% of patients with VTE were initiated on VKA, rivaroxaban, apixaban, and dabigatran. Patients with previous VTE, chronic kidney disease, liver disease, cancer, and thrombophilia were more likely to be initiated on VKA compared with one of the NOACs. In conclusion the initiation of rivaroxaban and apixaban is increasing significantly over time in patients with VTE. Patients with previous VTE, chronic kidney disease, liver disease, cancer, and thrombophilia were more likely to be initiated on VKA compared with rivaroxaban or apixaban.
丹麦全国性登记处被用于调查静脉血栓栓塞症（VTE）患者开始使用利伐沙班、阿哌沙班或达比加群与维生素 K 拮抗剂（VKA）的时间趋势。在 2012 年 2 月至 2016 年 9 月期间，确定了使用一种新型口服抗凝剂（NOAC）（利伐沙班、达比加群、阿哌沙班）或 VKA 治疗的患者。共纳入 19578 例患者，其中 10844 例（55.4%）接受 VKA 治疗，8734 例（44.6%）接受 NOAC 治疗（利伐沙班 7572 例，阿哌沙班 1066 例，达比加群 96 例）。时间趋势显示 VKA 的起始使用量减少（趋势下降 p 值<0.0001），利伐沙班和阿哌沙班的起始使用量增加（趋势增加 p 值<0.0001）。到 2016 年 9 月，12%、70%、16%和 2%的 VTE 患者开始使用 VKA、利伐沙班、阿哌沙班和达比加群。与一种新型口服抗凝剂相比，有先前 VTE、慢性肾脏病、肝病、癌症和血栓形成倾向的患者更有可能开始使用 VKA。总之，VTE 患者开始使用利伐沙班和阿哌沙班的时间呈显著增加趋势。与利伐沙班或阿哌沙班相比，有先前 VTE、慢性肾脏病、肝病、癌症和血栓形成倾向的患者更有可能开始使用 VKA。
