Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017
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Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017. / Grundtvig, Josefine; Ovesen, Christian; Havsteen, Inger; Christensen, Thomas; Gaist, David; Iversen, Helle K.; Kruuse, Christina; Lilja-Cyron, Alexander; Ægidius, Karen; Rosenbaum, Sverre; Meden, Per; Marstrand, Jacob; Christensen, Louisa; Steiner, Thorsten; Christensen, Hanne.
I: European Stroke Journal, Bind 6, Nr. 2, 2021, s. 143-150.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017
AU - Grundtvig, Josefine
AU - Ovesen, Christian
AU - Havsteen, Inger
AU - Christensen, Thomas
AU - Gaist, David
AU - Iversen, Helle K.
AU - Kruuse, Christina
AU - Lilja-Cyron, Alexander
AU - Ægidius, Karen
AU - Rosenbaum, Sverre
AU - Meden, Per
AU - Marstrand, Jacob
AU - Christensen, Louisa
AU - Steiner, Thorsten
AU - Christensen, Hanne
N1 - Publisher Copyright: © European Stroke Organisation 2021.
PY - 2021
Y1 - 2021
N2 - Introduction: Non-vitamin K-antagonist oral anticoagulants (NOAC) have become first choice oral anticoagulant (OAC) with decreasing use of vitamin K antagonists (VKA), partly due to lower risk of intracerebral hemorrhage (ICH). Aim: to identify trends in sale of OACs and relate them to trends in OAC-related ICH (OAC-ICH). Patients and methods: Study was based on the population in the Capital Region of Denmark (1.8 million inhabitants). We identified all patients admitted with a non-traumatic OAC-ICH in 2010–2017 and ascertained diagnosis and drug use through medical charts. We used information available in the public domain on sale of defined daily doses (DDD) of OAC in the Capital Region of Denmark. Results: 453 patients with OAC-ICH out of a total of 2877 ICH-events were identified. From 2010 to 2017 sale of NOAC rose from 0.1 to 11.8 DDD/1000 inhabitants/day (p < 0.001); while VKA sale decreased from 7.6 to 5.2 DDD/1000 inhabitants/day (p < 0.001). The total number of ICH events was stable between 2010 and 2017, but the proportion of OAC-ICH events increased from 13% in 2010 to 22% in 2017 (p < 0.001). The proportion of ICH events related to NOAC had a significant increasing trend (p < 0.001), whereas a decreasing trend was observed for VKA (p = 0.04). Discussion: In Denmark, the population on OACs has increased; resulting from increased use of NOACs. Parallel to this development, the proportion of OAC-ICH overall has increased based on an increasing trend in NOAC-related ICH. Conclusion: Our findings document a need for further research on prevention and treatment of this complication.
AB - Introduction: Non-vitamin K-antagonist oral anticoagulants (NOAC) have become first choice oral anticoagulant (OAC) with decreasing use of vitamin K antagonists (VKA), partly due to lower risk of intracerebral hemorrhage (ICH). Aim: to identify trends in sale of OACs and relate them to trends in OAC-related ICH (OAC-ICH). Patients and methods: Study was based on the population in the Capital Region of Denmark (1.8 million inhabitants). We identified all patients admitted with a non-traumatic OAC-ICH in 2010–2017 and ascertained diagnosis and drug use through medical charts. We used information available in the public domain on sale of defined daily doses (DDD) of OAC in the Capital Region of Denmark. Results: 453 patients with OAC-ICH out of a total of 2877 ICH-events were identified. From 2010 to 2017 sale of NOAC rose from 0.1 to 11.8 DDD/1000 inhabitants/day (p < 0.001); while VKA sale decreased from 7.6 to 5.2 DDD/1000 inhabitants/day (p < 0.001). The total number of ICH events was stable between 2010 and 2017, but the proportion of OAC-ICH events increased from 13% in 2010 to 22% in 2017 (p < 0.001). The proportion of ICH events related to NOAC had a significant increasing trend (p < 0.001), whereas a decreasing trend was observed for VKA (p = 0.04). Discussion: In Denmark, the population on OACs has increased; resulting from increased use of NOACs. Parallel to this development, the proportion of OAC-ICH overall has increased based on an increasing trend in NOAC-related ICH. Conclusion: Our findings document a need for further research on prevention and treatment of this complication.
KW - direct oral anticoagulants
KW - hemorrhagic stroke
KW - intracerebral hemorrhage
KW - new oral anticoagulants
KW - Non-vitamin K-antagonist oral anticoagulants
KW - vitamin K-antagonists
U2 - 10.1177/23969873211008770
DO - 10.1177/23969873211008770
M3 - Journal article
C2 - 34414289
AN - SCOPUS:85104268265
VL - 6
SP - 143
EP - 150
JO - European Stroke Journal
JF - European Stroke Journal
SN - 2396-9873
IS - 2
ER -
ID: 280559748