J Korean Med Sci.
2018 Dec;33(49):e323. 10.3346/jkms.2018.33.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
- Oh S
- Kim JS
- Oh YS
- Shin DG
- Pak HN
- Hwang GS
- Choi KJ
- Kim JB
- Lee MY
- Park HW
- Kim DK
- Jin ES
- Park J
- Oh IY
- Shin DH
- Park HS
- Kim JH
- Kim NH
- Ahn MS
- Seo BJ
- Kim YJ
- Kang S
- Lee J
- Kim YH
- Affiliations
-
- 1Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- 2Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 4Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
- 5Department of Internal Medicine, Severance Hospital, Yonsei University Health System, Seoul, Korea.
- 6Department of Internal Medicine, Ajou University Hospital, Suwon, Korea.
- 7Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 8Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
- 9Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 10Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
- 11Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 12Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
- 13Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.
- 14Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 15Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea.
- 16Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea.
- 17Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam, Korea.
- 18Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea.
- 19Department of Internal Medicine, Yonsei University, Wonju Severance Christian Hospital, Wonju, Korea.
- 20Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
- 21Department of Internal Medicine-Medical, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
- 22Department of Biostatistics, Korea University College of Medicine, Seoul, Korea.
- 23Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. yhkmd@unitel.co.kr
- KMID: 2469939
- DOI: http://doi.org/10.3346/jkms.2018.33.e323
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.
