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.
10.3346/jkms.2018.33.e323
- Author:
Seil OH
1
;
June Soo KIM
;
Yong Seog OH
;
Dong Gu SHIN
;
Hui Nam PAK
;
Gyo Seung HWANG
;
Kee Joon CHOI
;
Jin Bae KIM
;
Man Young LEE
;
Hyung Wook PARK
;
Dae Kyeong KIM
;
Eun Sun JIN
;
Jaeseok PARK
;
Il Young OH
;
Dae Hee SHIN
;
Hyoung Seob PARK
;
Jun Hyung KIM
;
Nam Ho KIM
;
Min Soo AHN
;
Bo Jeong SEO
;
Young Joo KIM
;
Seongsik KANG
;
Juneyoung LEE
;
Young Hoon KIM
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Atrial Fibrillation;
Anticoagulation;
Vitamin K Antagonist;
INR Control;
Satisfaction
- MeSH:
Atrial Fibrillation*;
Drug Interactions;
Follow-Up Studies;
Humans;
International Normalized Ratio;
Male;
Prospective Studies;
Risk Factors;
Stroke;
Thromboembolism;
Vitamin K*;
Vitamins*
- From:Journal of Korean Medical Science
2018;33(49):e323-
- CountryRepublic of Korea
- Language:English
-
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.