ORIGINAL ARTICLE
Ahead of print publication

Trends in oral anticoagulant use – A 10-year retrospective analysis from a general medicine department of a tertiary care hospital in south India

Correspondence Address:
VV Thomas,
Department of Internal Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpgm.jpgm_10_23

PMID: 37470633

Background: The prescribing practice of newer oral anticoagulants (NOACs) has not been adequately studied in the Indian scenario.
Aims: We aimed to describe the prescribing practices of oral anticoagulants, the patient profile and medical comorbidities among patients admitted in a general medicine unit.
Methods: In this retrospective study of the 2742 patients prescribed vitamin- K antagonists (VKAs), during the study period, 150 cases were randomly taken for analysis to match the 105 NOACs cases. Their demographic details, clinical characteristics and treatment details were analyzed.
Results: More than 95% of anticoagulants prescribed were VKAs. The prescription of anticoagulants was more common in men (median age 63 years) for prescription of NOACs and 52 years for VKAs. Dabigatran (60.9%) and warfarin (81.3%) were the most prescribed drugs in their respective classes. The most common indication was for cardiovascular diseases with atrial fibrillation (32%). Diabetes and hypertension were the most common comorbidities in patients prescribed oral anticoagulants with a larger proportion of patients with heart failure being prescribed VKAs (P < 0.01). Patients in the NOACs group had a higher HAS-BLED high-risk score (33.3% vs. 17.3%; P = 0.002). Logistic regression analysis revealed that patients with co-morbidities of congestive heart failure were more likely to be prescribed VKAs while diabetics were more likely to receive NOACs.
Conclusions: VKAs were the most prescribed anticoagulants; congestive heart failure, diabetes, and hypertension were the commonest comorbidities; and atrial fibrillation was the commonest indication. Patients with a high HAS-BLED score were prescribed NOACs more often.

Keywords: Cardiac failure, dabigatran, newer oral anticoagulants, prescription practice, warfarin