Prevalence and risk of inappropriate dosing of direct oral anticoagulants in two Swiss atrial fibrillation registries

Montrasio, Giulia; Reiner, Martin F; Wiencierz, Andrea; Aeschbacher, Stefanie; Baumgartner, Christine; Rodondi, Nicolas; Kühne, Michael; Moschovitis, Giorgio; Preiss, Helga; Coslovsky, Michael; De Perna, Maria L; Bonati, Leo H; Conen, David; Osswald, Stefan; Beer, Juerg H; Koepfli, Pascal

doi:10.1016/j.vph.2022.107120

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Montrasio, G., Reiner, M. F., Wiencierz, A., Aeschbacher, S., Baumgartner, C., Rodondi, N., Kühne, M., Moschovitis, G., Preiss, H., Coslovsky, M., De Perna, M. L., Bonati, L. H., Conen, D., Osswald, S., Beer, J. H., & Koepfli, P. (2022). Prevalence and risk of inappropriate dosing of direct oral anticoagulants in two Swiss atrial fibrillation registries. Vascular Pharmacology, 147, 107120. https://doi.org/10.1016/j.vph.2022.107120

Abstract

BACKGROUND

Direct oral anticoagulants (DOACs) have a favourable risk-benefit profile compared to vitamin K-antagonists (VKAs) in atrial fibrillation (AF). Dosing is based on age, weight and renal function, without need of routine monitoring.

METHODS AND RESULTS

In two prospective, multicentre AF cohorts (Swiss-AF, BEAT-AF) patients were stratified as receiving VKAs or adequately-, under- or overdosed DOACs, according to label. Primary outcome was a composite of major adverse clinical events (MACE), defined as cardiovascular death,