Objective

To determine compliance to anticoagulant therapy and the time in therapeutic range (TTR) in patients with non-valvular atrial fibrillation (NVAF) who were on oral anticoagulant therapy with vitamin K antagonist in tertiary reference center setting in Turkey.

Methods

This multicenter, observational study included ≥18 year-old patients diagnosed with NVAF from August 2012 through November 2013. Patients with cognitive disorders, postoperative NVAF, or NVAF due to reversible causes, those having myocardial infarction or undergoing any operations within the last 3 months, those who participated in another clinical trial in the last 6 months, and pregnant or breastfeeding females were excluded. Data regarding therapeutic approaches and compliance to therapies were recorded at baseline, 6th month, and 12th month. Descriptive statistics were expressed as numbers and percentages for categorical variables and as median (minimum-maximum) for numerical variables.

Results

The median age of the patients (n=210; males, 57.1%) was 65 years (range, 20-88 years). Of the study group, 61.4% were inpatient. According to AF types, 43.8% of the patients had permanent AF, 32.9% had paroxysmal AF, and 23.3% had persistent AF. At baseline, 6th month, and 12th month, 84.3%, 96.6%, and 97.1% of the patients were on antithrombotic therapy, respectively. The dosage was changed in 21.3% of the patients at the 6th month and 21.4% of the patients at the 12th month. Details of patients who continued or were switched from their baseline anticoagulation strategy at the 12th month are shown in Figure 1.

The primary reason for changing drugs was being outside the therapeutic INR range (Table 1). The TTR was 72.9% in the patients (n=43) with the therapeutic INR range of 2-3.