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J Korean Med Sci. 2018;33(49):e323.

Quality of Anticoagulation and Treatment Satisfaction in Patients with Non-Valvular Atrial Fibrillation Treated with Vitamin K Antagonist: Result from the KORean Atrial Fibrillation Investigation II.

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제1저자 오세일 · 교신저자 김영훈

소속 (23)
  1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  2. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  3. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  4. Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
  5. Department of Internal Medicine, Severance Hospital, Yonsei University Health System, Seoul, Korea.
  6. Department of Internal Medicine, Ajou University Hospital, Suwon, Korea.
  7. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  8. Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
  9. Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  10. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
  11. Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
  12. Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
  13. Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
  14. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  15. Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea.
  16. Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea.
  17. Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam, Korea.
  18. Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
  19. Department of Internal Medicine, Yonsei University, Wonju Severance Christian Hospital, Wonju, Korea.
  20. Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
  21. Department of Internal Medicine-Medical, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
  22. Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
  23. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction.

METHODS We conducted a multicenter, prospective, non-interventional study. Patients with CHADS2 ≥ 1 and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up.

RESULTS A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had CHADS2 ≥ 2 and 83.6% had CHA2DS2-VASc ≥ 2. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain.

CONCLUSION INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

Keywords

AnticoagulationAtrial FibrillationINR ControlSatisfactionVitamin K Antagonist

Figures

Fig. 1
Fig. 1 Kaplan-Meier curve of time to optimal dose for VKA treatment with two-consecutive dose maintaining. VKA = vitamin K antagonist, CI = confidence interval.
Fig. 2
Fig. 2 Dissatisfaction with the VKA use. VKA = vitamin K antagonist.

그림 출처: PubMed Central 공개 논문 (PMC6262187)

Conflict of interest statement

Disclosure: The authors have no potential conflicts of interest to disclose.

그 밖의 정보
출판 형태
Journal Article
저널
Journal of Korean medical science · eISSN 1598-6357
전자 출판
2018-11-21
MeSH
Aged · Anticoagulants / therapeutic use · Atrial Fibrillation / drug therapy / mortality · Female · Humans · International Normalized Ratio · Kaplan-Meier Estimate · Male · Middle Aged · Personal Satisfaction* · Prospective Studies · Republic of Korea · Surveys and Questionnaires · Vitamin K / therapeutic use
Substances
Anticoagulants · Vitamin K
참고문헌
33편