New analysis on persistence of atrial fibrillation patients with VKAs

In a new German claims data analysis, an INGRESS team published results of a study that described persistence with vitamin K antagonist (VKA) treatment in German atrial fibrillation (AF) patients and identified factors which may be associated with early discontinuation of VKA therapy.

In the study, 38,076 VKA patients who started a VKA therapy (mean age 76.13 years; 56.08% female; mean CHA2DS2-VASc-Score 4.49; mean Charlson Comorbidity Index (CCI) 3.91) were identified. After four quarters since start of VKA treatment, 14,889 (39.10%) of observed patients had discontinued their VKA treatment (after eight quarters: 54.61%). Mean time until treatment discontinuation was 390.55 days. Risk of VKA discontinuation increased with the diagnosis of dementia within the first two quarters of VKA treatment [HR 1.35 (95% CI 1.29–1.40)], diagnosed alcohol or drug abuse in the baseline period [HR 1.25; 95% CI 1.18–1.33)], female gender [HR 1.08; 95% CI 1.05–1.10)], higher age (HR 1.03; 95% CI 1.03–1.03), higher CCI (HR 1.05; 95% CI 1.04–1.05), any prescription of NSAID (HR 1.07; 95% CI 1.04–1.10), and number of surgeries in the first two quarters of VKA treatment (HR 1.05; 95% CI 1.04–1.05). At least one yearly visit to a cardiologist since start of VKA treatment decreased the risk of non-persistence [HR 0.90; 95% CI 0.88–0.93] and a cancer diagnosis in the baseline period (HR 0.92; 95% CI 0.89–0.96).

So, this study concluded that non-persistence related to VKA therapy is common in AF patients.