J Cardiovasc Imaging.  2021 Jul;29(3):265-278. 10.4250/jcvi.2021.0014.

Epidemiology of Venous Thromboembolism and Treatment Pattern of Oral Anticoagulation in Korea, 2009–2016: a Nationwide Study Based on the National Health Insurance Service Database

Affiliations
  • 1Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
  • 2Department of Internal Medicine, Cardiovascular Imaging Center, Heart, Vascular & Stroke Institute, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 3Department of Neurology and Stroke Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 4Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 5Division of Cardiology, Department of Internal Medicine, Busan Paik Hospital, Inje University, Busan, Korea
  • 6Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea
  • 7Department of Cardiovascular Medicine, Wonkwang University Hospital, Iksan, Korea
  • 8Department of Cardiology in Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
  • 9Department of Cardiology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

BACKGROUND
The annual incidence of venous thromboembolism (VTE) is increasing, and the treatment pattern of oral anticoagulants (OACs) has changed with introduction of new oral anticoagulants (NOACs). The aims of this study were to assess the annual incidence of VTE in a Korean population and the change of treatment pattern with availability of NOACs using a population-based database.
METHODS
Using the Korean National Health Insurance Services database, we identified patients diagnosed with VTE between 2009 and 2016. The annual prevalence of VTE and clinical characteristics and treatment pattern were investigated. The annual incidence of VTE was calculated using direct and indirect methods using the estimated Korean population in 2009 as the reference.
RESULTS
The annual incidence of VTE in Korean has increased yearly from 23.9 per 100,000 in 2009 to 42.2 in 2016. The overall rate of OAC prescription for VTE treatment increased from 55.9% to 68% in the same time period. The rate of initiation of NOAC treatment greatly increased, particularly from 2013 onwards, with a 20-fold increase from 2009 to 2016 (2.1% vs. 54.3%).
CONCLUSIONS
The annual incidence of VTE in Korea increased by almost two-fold from 2009 to 2016. The rate of initiation of NOAC treatment has increased substantially since 2013, and these agents have surpassed VKAs as the anticoagulant of choice for VTE. This temporal pattern of OAC prescription is consistent with the current clinical guidelines, which indicate NOACs over the warfarin in patients with VTE.

Keyword

Annual incidence; Oral anticoagulants; NOACs; Temporal trend; Venous thromboembolism
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