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KMID : 0191120180330490323
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Journal of Korean Medical Science
2018 Volume.33 No. 49 p.323 ~ p.323
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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
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Oh Se-Il
Kim June-Soo
Oh Yong-Seog
Shin Dong-Gu
Pak Hui-Nam
Hwang Gyo-Seung
Choi Kee-Joon
Kim Jin-Bae
Lee Man-Young
Park Hyung-Wook
Kim Dae-Kyeong
Jin Eun-Sun
Park Jae-Seok
Oh Il-Young
Shin Dae-Hee
Park Hyoung-Seob
Kim Jun-Hyung
Kim Nam-Ho
Ahn Min-Soo
Seo Bo-Jeong
Kim Young-Joo
Kang Seong-Sik
Lee June-Young
Kim Young-Hoon
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Abstract
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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.
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KEYWORD
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Atrial Fibrillation, Anticoagulation, Vitamin K Antagonist, INR Control, Satisfaction
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