Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants

• DOI: 10.2147/ppa.s88994
• Publication Date: 2015-11-23T19:36:06Z
• Authors: Pfeilschifter; Sebastian Luger; Carina Hohmann; Daniela Niemann; Peter Kraft; Ignaz Gunreben; Tobias Neumann-Ha...; Christoph Kleinsc...; Helmuth Steinmetz; Christian Foerch
• Keywords: Stroke; Oral anticoagulant

Background: Oral anticoagulant therapy (OAT) potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA) have been the standard of care for long-term OAT decades, but non-VKA oral anticoagulants (NOAC) recently approved this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA NOAC secondary stroke prevention. Methods: All treated from October 2011 September 2012 ischemic or transient attack a subsequent indication OAT, at three academic hospitals were entered into prospective registry, baseline data antithrombotic treatment discharge recorded. At 1-year follow-up, we different strategies patients' respective OAT. noted changes, reasons change treatment, factors that persistence prescribed Results: In discharged achieved fatality corrected response rate 73.3% (n=209). A total 92% these received follow-up. observed good both (VKA, 80.9%; NOAC, 74.8%; P =0.243) statistically nonsignificant tendency toward weaker dabigatran. Disability follow-up was an independent predictor lower any after multivariate analysis, whereas choice did not relevant influence. Conclusion: One-year is strong (>90%) who switch most commonly another The rates prevention do differ significantly between therapeutic strategies. Keywords: stroke, prevention, vitamin antagonists, anticoagulants,