Introduction
Methods
Results
Belgium and the Netherlands compared with other European countries
Belgium and the Netherlands | Other European countries | |||||
---|---|---|---|---|---|---|
Characteristics | Overall (n = 2579) | 60 mg OD (n = 2197) | 30 mg OD (n = 382) | Overall (n = 11,060) | 60 mg OD (n = 8248) | 30 mg OD (n = 2812) |
30 mg users | 382 (14.8) | 0 (0.0) | 382 (100.0) | 2812 (25.4) | 0 (0.0) | 2812 (100.0) |
Male | 1514 (58.8) | 1356 (61.8) | 158 (41.4) | 6193 (56.0) | 4961 (60.1) | 1232 (43.8) |
Age (years) | 72.3 ± 9.1 | 71.2 ± 8.7 | 78.9 ± 8.4 | 73.9 ± 9.6 | 71.9 ± 9.3 | 79.7 ± 7.8 |
Age subgroups (years) | ||||||
– <65 | 439 (17.0) | 422 (19.2) | 17 (4.5) | 1658 (15.0) | 1541 (18.7) | 117 (4.2) |
– 65–74 | 1056 (41.0) | 969 (44.1) | 87 (22.8) | 3550 (32.1) | 3062 (37.1) | 488 (17.4) |
– 75–84 | 882 (34.2) | 704 (32.1) | 178 (46.6) | 4618 (41.8) | 3191 (38.7) | 1427 (50.8) |
– ≥85 | 200 (7.8) | 100 (4.6) | 100 (26.2) | 1232 (11.1) | 453 (5.5) | 779 (27.7) |
Weight (kg) | 82.3 ± 17.4 | 84.1 ± 16.9 | 72.3 ± 17.2 | 80.7 ± 17.3 | 83.4 ± 16.7 | 72.9 ± 16.6 |
BMI (kg/m2) | 28.0 ± 5.1 | 28.3 ± 5.0 | 26.1 ± 4.9 | 28.1 ± 5.2 | 28.7 ± 5.1 | 26.6 ± 5.1 |
Blood pressure (mm Hg) | ||||||
– Systolic | 136.3 ± 20.3 | 135.9 ± 20.2 | 138.1 ± 21.0 | 132.8 ± 17.4 | 133.1 ± 17.1 | 131.9 ± 18.0 |
– Diastolic | 78.8 ± 12.4 | 79.3 ± 12.3 | 76.0 ± 12.1 | 78.2 ± 10.5 | 78.9 ± 10.5 | 76.2 ± 10.4 |
Active smokers | 208 (8.1) | 184 (8.4) | 24 (6.3) | 651 (5.9) | 535 (6.5) | 116 (4.1) |
No alcohol use | 629 (24.4) | 501 (22.8) | 128 (33.5) | 5483 (49.7) | 3880 (47.1) | 1603 (57.0) |
CrCla (ml/min) | 78.4 ± 29.7 | 83.7 ± 28.2 | 49.6 ± 19.3 | 73.5 ± 30.6 | 81.9 ± 29.5 | 50.3 ± 19.8 |
CrCla subgroups (ml/min) | ||||||
– <15 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (0.0) | 0 (0.0) | 2 (0.1) |
– 15–30 | 45 (2.0) | 9 (0.5) | 36 (10.5) | 250 (2.6) | 30 (0.4) | 220 (8.7) |
– 30–50 | 276 (12.5) | 113 (6.0) | 163 (47.5) | 1899 (19.8) | 585 (8.3) | 1314 (51.7) |
– 50–80 | 953 (43.0) | 830 (44.4) | 123 (35.9) | 4095 (42.7) | 3286 (46.6) | 809 (31.8) |
– ≥80 | 940 (42.5) | 919 (49.1) | 21 (6.1) | 3349 (34.9) | 3152 (44.7) | 197 (7.7) |
Renal disease | 360 (14.0) | 206 (9.4) | 154 (40.3) | 3329 (30.1) | 1836 (22.3) | 1493 (53.1) |
CHADS2a | 1.5 ± 1.1 | 1.4 ± 1.1 | 2.0 ± 1.1 | 1.8 ± 1.1 | 1.7 ± 1.0 | 2.2 ± 1.0 |
CHA2DS2-VASca | 2.8 ± 1.4 | 2.6 ± 1.4 | 3.6 ± 1.3 | 3.2 ± 1.4 | 3.0 ± 1.4 | 3.8 ± 1.3 |
– Score of 0 | 99 (3.8) | 97 (4.4) | 2 (0.5) | 211 (1.9) | 203 (2.5) | 8 (0.3) |
– Score of ≥1 | 2480 (96.2) | 2100 (95.6) | 380 (99.5) | 10,849 (98.1) | 8045 (97.5) | 2804 (99.7) |
HAS-BLEDa | 2.4 ± 1.2 | 2.3 ± 1.1 | 2.9 ± 1.2 | 2.6 ± 1.1 | 2.5 ± 1.1 | 3.0 ± 1.1 |
Frailtyb | ||||||
– Yes | 153 (5.9) | 80 (3.6) | 73 (19.1) | 1289 (11.7) | 556 (6.8) | 733 (26.1) |
– No | 2184 (84.7) | 1915 (87.2) | 269 (70.4) | 9076 (82.2) | 7192 (87.4) | 1884 (67.0) |
– Unknown | 240 (9.3) | 200 (9.1) | 40 (10.5) | 677 (6.1) | 482 (5.9) | 195 (6.9) |
History of cardiovascular diseases | ||||||
– Hypertension | 1589 (61.6) | 1335 (60.8) | 254 (66.5) | 8891 (80.4) | 6588 (79.9) | 2303 (81.9) |
– CHF | 109 (4.2) | 73 (3.3) | 36 (9.4) | 690 (6.2) | 422 (5.1) | 268 (9.5) |
– MI | 130 (5.0) | 94 (4.3) | 36 (9.4) | 454 (4.1) | 293 (3.6) | 161 (5.7) |
– Angina pectoris | 47 (1.8) | 37 (1.7) | 10 (2.6) | 154 (1.4) | 97 (1.2) | 57 (2.0) |
– Valvular disease | 345 (13.4) | 252 (11.5) | 93 (24.3) | 2081 (18.8) | 1445 (17.5) | 636 (22.6) |
– PAD | 93 (3.6) | 79 (3.6) | 14 (3.7) | 365 (3.3) | 214 (2.6) | 151 (5.4) |
– DM | 445 (17.3) | 360 (16.4) | 85 (22.3) | 2551 (23.1) | 1782 (21.6) | 769 (27.3) |
History of stroke | ||||||
– Ischaemic | 154 (6.0) | 121 (5.5) | 33 (8.6) | 662 (6.0) | 472 (5.7) | 190 (6.8) |
– Cryptogenic | 10 (0.4) | 9 (0.4) | 1 (0.3) | 71 (0.6) | 44 (0.5) | 27 (1.0) |
– TIA | 129 (5.0) | 105 (4.8) | 24 (6.3) | 334 (3.0) | 238 (2.9) | 96 (3.4) |
History of bleeding | ||||||
– Gastrointestinalc | 19 (0.7) | 14 (0.6) | 5 (1.3) | 89 (0.8) | 39 (0.5) | 50 (1.8) |
– Major | 31 (1.2) | 24 (1.1) | 7 (1.8) | 102 (0.9) | 58 (0.7) | 44 (1.6) |
– Intracranial | 19 (0.7) | 16 (0.7) | 3 (0.8) | 48 (0.4) | 30 (0.4) | 18 (0.6) |
Atrial fibrillation type | ||||||
– Paroxysmal | 1668 (64.9) | 1417 (64.7) | 251 (65.7) | 5612 (50.9) | 4261 (51.9) | 1351 (48.1) |
– Persistent | 585 (22.8) | 500 (22.8) | 85 (22.3) | 2724 (24.7) | 2131 (25.9) | 593 (21.1) |
– Long-standing persistent | 30 (1.2) | 27 (1.2) | 3 (0.8) | 303 (2.7) | 217 (2.6) | 86 (3.1) |
– Permanent | 228 (11.2) | 245 (11.2) | 43 (11.3) | 2382 (21.6) | 1606 (19.5) | 776 (27.7) |
Burden of atrial fibrillation | ||||||
– Symptomatic | 1479 (57.4) | 1285 (58.6) | 194 (50.8) | 5776 (52.3) | 4404 (53.5) | 1372 (48.8) |
– Asymptomatic | 856 (33.2) | 714 (32.5) | 142 (37.2) | 3762 (34.1) | 2758 (33.5) | 1004 (35.7) |
– Unknown | 241 (9.4) | 195 (8.9) | 46 (12.0) | 1500 (13.6) | 1066 (13.0) | 434 (15.4) |
Time since the diagnosis of atrial fibrillation (months) | ||||||
– Median (IQR) | 1.9 (0.3; 27.5) | 1.9 (0.3; 28.1) | 2.0 (0.2; 20.1) | 5.5 (0.5; 29.7) | 4.8 (0.4; 26.3) | 7.5 (0.8; 39.1) |
Previous (not current) use of atrial fibrillation relevant medication | ||||||
– VKA | 540 (20.9) | 469 (21.3) | 71 (18.6) | 1781 (16.1) | 1238 (15.0) | 543 (19.3) |
– NOAC (other) | 174 (6.7) | 136 (6.2) | 38 (9.9) | 924 (8.4) | 588 (7.1) | 336 (11.9) |
– Rate- or rhythm | 238 (9.2) | 201 (9.1) | 37 (9.7) | 445 (4.0) | 327 (4.0) | 118 (4.2) |
– Antiplatelets | 498 (19.3) | 414 (18.8) | 84 (22.0) | 1572 (14.2) | 1137 (13.8) | 435 (15.5) |
Number of dose adjustment criteriad | ||||||
– 0 | 2127 (82.5) | 1986 (90.4) | 141 (36.9) | 8293 (75.0) | 7295 (88.4) | 998 (35.5) |
– ≥1 | 452 (17.5) | 211 (9.6) | 241 (63.1) | 2767 (25.0) | 953 (11.6) | 1814 (64.5) |
Dose adjustment criteriad | ||||||
– CrCla ≤50 ml/min | 321 (14.5) | 122 (6.5) | 199 (58.0) | 2151 (22.4) | 615 (8.7) | 1536 (60.4) |
– Weight ≤60 kg | 211 (8.9) | 98 (4.8) | 113 (31.7) | 1158 (10.7) | 409 (5.1) | 749 (27.2) |
Belgium and the Netherlands: clinical practice versus the phase III trial
Characteristics | ETNA-AF-Europe (n = 2579) | ENGAGE-AF-TIMI 48 (n = 302) |
---|---|---|
Male | 1514 (58.8) | 196 (64.9) |
Age (years) | 72.3 ± 9.1 | 71.5 ± 7.6 |
Age subgroups (years) | ||
– <65 | 439 (17.0) | 53 (17.5) |
– 65–74 | 1056 (41.0) | 102 (33.8) |
– ≥75 | 1082 (42.0) | 147 (48.7) |
Body weight (kg) | 82.3 ± 17.4 | 84.6 ± 16.5 |
– ≤60 kg | 211 (8.9) | 11 (3.6) |
BMI (kg/m2) | 28.0 ± 5.1 | 28.8 ± 5.0 |
CrCla (ml/min) | 78.4 ± 29.7 | 73.4 ± 25.7 |
CrCl subgroupsa (ml/min) | ||
– <15 | 0 (0.0) | 1 (0.3) |
– 15–30 | 45 (2.0) | 2 (0.7) |
– 30–50 | 276 (12.5) | 51 (17.1) |
– 50–80 | 953 (43.0) | 147 (49.3) |
– ≥80 | 940 (42.5) | 97 (32.6) |
CHADS2a | 1.5 ± 1.1 | 2.7 ± 0.9 |
CHA2DS2-VASca | 2.8 ± 1.4 | 4.2 ± 1.3 |
HAS-BLEDa | 2.4 ± 1.2 | 1.6 ± 1.0 |
History of cardiovascular disease | ||
– Hypertension | 1589 (61.6) | 252 (83.4) |
– Congestive heart failure | 109 (4.2) | 94 (31.1) |
– Myocardial infarction | 130 (5.0) | 40 (13.2) |
– Diabetes mellitus | 445 (17.3) | 127 (42.1) |
– Ischaemic stroke | 154 (6.0) | 49 (16.2) |
– Transient ischaemic attack | 129 (5.0) | 52 (17.2) |
Atrial fibrillation type | ||
– Paroxysmal | 1668 (64.9) | 117 (38.7) |
– Persistent | 585 (22.8) | 77 (25.5) |
– Long-standing persistent or permanent | 318 (12.4) | 108 (35.8) |