Satisfaction with oral anticoagulants in patients with atrial fibrillation

Figures & data

Table 1 Clinical characteristics of the study population

Variable	Total (n=1,309)
Age (years)	78.5±8.4
Sex male (%)	49.3
Level of dependency (%)
No dependency	59.9
Partial dependency	34.4
Total dependency	5.7
Permanent atrial fibrillation (%)	82.9
Hypertension (%)	86.7
Heart failure (%)	58.7
Glomerular filtration ≤60 mL/min/1.73 m^2 (%)	57.2
Diabetes (%)	40.4
Prior stroke (%)	19.4
Mean CHADS2 score	3.2±1.2
Mean CHA2 DS2-VASc score	4.9±1.5
Mean HAS-BLED score	2.0±0.9
Charlson Comorbidity Index	2.3±1.8
Polymedicated (≥5 tablets, %)	90.7
TRT ≤50% (only in VKA patients, %)	50.6

Abbreviations: TRT, time in the therapeutic range; VKA, vitamin K antagonists.

Table 2 ACTS Burdens scale according to different clinical characteristics and the type of oral anticoagulant

	Total (n=1,309)	P-value	VKA (n=902)	DOACs (n=407)	P-value
Overall	49.69±9.45	–	48.12±9.79	53.15±7.59	<0.001
Sex
Men	50.44±9.31	0.001	48.67±9.98	54.14±6.29	<0.001
Women	48.95±9.54		47.60±9.59	52.12±8.65	<0.001
Age
18–65 years	46.70±9.49		44.55±9.95	52.86±4.18	0.005
66–75 years	48.31±9.94	NS*	46.68±10.31	51.57±8.36	0.01
76–85 years	49.97±9.28		48.07±9.61	53.74±7.24	<0.001
≥86 years	49.71±9.50		48.75±9.86	52.49±7.78	0.001
Level of dependency
No dependency	50.95±8.74		49.25±9.25	54.59±6.13	<0.001
Partial dependency	48.02±9.94	<0.001*	47.01±10.09	50.44±9.14	0.01
Total dependency	46.53±11.14		43.10±10.98	53.40±7.95	<0.001
Glomerular filtration
≤60 mL/min/1.73 m^2	48.90±9.82	0.008	47.45±10.19	52.47±7.79	<0.001
>60 mL/min/1.73 m^2	50.39±9.08		48.63±9.34	53.86±7.43	<0.001
Site of INR determination	(only in VKA patients)
Self-monitoring	49.80±8.96		49.80±8.96
Primary care center	49.38±8.99	<0.001*	49.38±8.99	–	–
Hematology department	43.83±10.94		43.83±10.94
Hospital (other than hematology department)	53.81±5.86		53.81±5.86
Number of INR determinations in the last 6 months	(only in VKA patients)
0–5	50.36±7.85		50.36±7.85
6–10	47.35±10.58	0.01*	47.35±10.58	–	–
>10	46.24±10.77		46.24±10.77
Number of pills
0–5	51.09±9.30		48.97±9.85	55.09±6.56	<0.001
6–10	50.24±9.01	0.01*	48.78±9.40	53.41±7.16	<0.001
11–15	48.79±9.98		47.17±10.39	52.66±7.66	<0.001
≥16	49.12±9.25		47.94±9.13	51.77±9.03	NS
Polymedication
<5 tablets	51.41±8.54	0.04	49.37±9.01	54.50±6.74	0.002
≥5 tablets	49.53±9.50		48.03±9.83	52.99±7.67	<0.001
Thromboembolic risk
CHA2 DS-VASc =0	54.50±2.12		–	54.50±2.12	–
CHA2 DS2-VASc =1	48.00±6.23	NS*	48.00±6.23	–	–
CHA2 DS2-VASc ≥2	49.68±9.50		48.09±9.82	53.20±7.65	<0.001
Bleeding risk
HAS-BLED =0	47.30±7.85		44.00±8.46	52.25±3.30	NS
HAS-BLED =1–2	49.89±9.66	0.01*	48.06±10.16	53.27±7.60	<0.001
HAS-BLED ≥3	48.72±9.40		47.72±9.58	51.94±8.04	0.001
Comorbidity
Absence	50.9±9.3		49.7±9.6	53.5±7.9	<0.001
Low	49.7±9.9	0.001*	47.8±10.1	54.5±7.4	<0.001
High	49.0±9.4		47.4±9.8	52.4±7.6	<0.001
TRT	(only in VKA patients)
≤50%	47.07±10.35	0.024	47.07±10.35	–	–
>50%	49.02±9.24		49.02±9.24
Duration of treatment with anticoagulants (months)
0–24	50.74±9.12		47.36±10.08	53.13±7.54	<0.001
25–48	50.41±8.75	<0.001*	49.32±8.87	53.39±7.73	0.003
48–96	48.17±9.49		47.61±9.59	54.41±5.24	0.001
>96	48.26±10.30		48.33±10.24	44.00±14.45	NS

Notes:

* P for trend. Data presented as mean ± SD unless otherwise indicated.

Abbreviations: ACTS, Anti-Clot-Treatment Scale; VKA, vitamin K antagonists; DOACs, direct oral anticoagulants; NS, not significant; INR, International Normalized Ratio; TRT, time in the therapeutic range.

Table 3 ACTS Benefits scale according to different clinical characteristics and the type of oral anticoagulant

	Total (n=1,309)	P-value	VKA (n=902)	DOACs (n=407)	P-value
Overall	11.35±2.61	–	11.06±2.58	11.99±2.56	<0.001
Sex
Men	11.49±2.57	0.03	11.17±2.57	12.17±2.45	<0.001
Women	11.21±2.64		10.96±2.59	11.81±2.67	0.001
Age
18–65 years	11.93±2.35		11.70±2.45	12.57±2.07	NS
66–75 years	11.70±2.29	0.01*	11.26±2.44	12.59±1.62	0.003
76–85 years	11.43±2.60		11.16±2.59	11.98±2.54	0.001
≥86 years	11.03±2.70		10.79±2.60	11.73±2.87	0.001
Level of dependency
No dependency	11.62±2.63		11.36±2.56	12.17±2.69	0.001
Partial dependency	11.00±2.53	<0.001*	10.73±2.56	11.65±2.36	<0.001
Total dependency	10.57±2.56		9.98±2.42	11.76±2.47	0.03
Glomerular filtration
≤60 mL/min/1.73 m^2	11.28±2.59	NS	11.04±2.55	11.88±2.59	<0.001
>60 mL/min/1.73 m^2	11.50±2.51		11.19±2.46	12.12±2.49	<0.001
Site of INR determination	(only in VKA patients)
Self-monitoring	12.20±3.83		12.20±3.83
Primary care center	11.20±2.52	0.001*	11.20±2.52	–	–
Hematology department	10.57±2.66		10.57±2.66
Hospital (other than hematology department)	12.27±2.55		12.27±2.55
Number of INR determinations in the last 6 months	(only in VKA patients)
0–5	11.59±2.27		11.59±2.27
6–10	10.86±2.61	<0.001*	10.86±2.61	–	–
>10	11.95±2.92		11.95±2.92
Number of pills
0–5	11.18±3.00		10.80±3.09	11.91±2.70	0.02
6–10	11.40±2.68	NS*	11.10±2.60	12.05±2.74	<0.001
11–15	11.36±2.47		11.12±2.42	11.94±2.51	0.001
≥16	11.31±2.40		11.04±2.47	11.89±2.15	0.02
Polymedication
<5 tablets	11.20±3.05	NS	10.81±3.10	11.79±2.89	NS
≥5 tablets	11.36±2.57		11.08±2.53	12.00±2.53	<0.001
Thromboembolic risk
CHA2 DS2-VASc =0	13.50±2.12		–	13.50±2.12	–
CHA2 DS2-VASc =1	10.67±1.75	NS*	10.67±1.75	–	–
CHA2 DS2-VASc ≥2	11.35±2.61		11.06±2.59	12.00±2.55	<0.001
Bleeding risk
HAS-BLED =0	11.70±2.31		11.50±2.43	12.00±2.45	NS
HAS-BLED =1–2	11.46±2.65	0.02*	11.19±2.61	11.95±2.64	<0.001
HAS-BLED ≥3	11.13±2.48		10.88±2.46	11.96±2.34	0.001
Comorbidity
Absence	11.4±2.8		11.2±2.7	11.9±2.9	0.004
Low	11.5±2.7	0.02*	11.2±2.7	12.3±2.8	<0.001
High	11.2±2.4		10.9±2.4	11.9±2.3	<0.001
TRT	(only in VKA patients)
≤50%	10.90±2.51	NS	10.90±2.51	–	–
>50%	11.13±2.68		11.13±2.68
Duration of treatment with anticoagulants (months)
0–24	11.44±2.72		10.86±2.72	11.86±2.64	<0.001
25–48	11.65±2.54	0.001*	11.48±2.57	12.14±2.41	NS
48–96	11.05±2.63		10.89±2.63	12.82±1.84	<0.001
>96	11.06±2.39		11.03±2.38	13.25±2.36	NS

Notes:

* P for trend. Data presented as mean ± SD unless otherwise indicated.

Abbreviations: ACTS, Anti-Clot-Treatment Scale; VKA, vitamin K antagonists; DOACs, direct oral anticoagulants; NS, not significant; INR, International Normalized Ratio; TRT, time in the therapeutic range.

Table 4 Variables associated with satisfaction of patients with oral anticoagulation

	P-value	Beta	95% CI
ACTS Burdens scale
Overall
Age	0.0005	1.674	0.733–2.614
Dependency	<0.0001	−3.625	−4.664 to −2.587
Type of oral anticoagulant	<0.0001	5.678	4.437–6.919
Glomerular filtration rate	0.013	1.491	0.315–2.667
VKA
Age	0.0021	2.131	0.778–3.484
Dependency	<0.0001	−4.893	−6.354 to −3.431
Number of INR controls	0.0039	−2.248	−3.77 to −0.725
Site of INR determination	<0.0001	−4.118	−5.632 to −2.604
DOACs
Dependency	0.0014	−2.263	−3.64 to −0.885
ACTS Benefits scale
Overall
Dependency	0.0003	−0.501	−0.773 to −0.229
Type of oral anticoagulant	<0.0001	0.957	0.628–1.287
Comorbidity	0.0008	−0.100	−0.158 to −0.041
VKA
Dependency	0.0003	−0.663	−1.021 to −0.306
Site of INR determination	0.0024	−0.592	−0.974 to −0.211
Comorbidity	0.0440	−0.084	−0.165 to −0.002
DOACs
Serum creatinine	0.0146	−0.736	−1.325 to −0.146

Abbreviations: ACTS, Anti-Clot-Treatment Scale; VKA, vitamin K antagonists; INR, International Normalized Ratio; DOACs, direct oral anticoagulants.