Stroke Prophylaxis of AF-patients: Real-life Effectiveness and Safety of Novel Anticoagulants Compared to VKA

Completed

Phase N/A Results N/A

Trial Description

The central questions of the study can be summarized as follows:
What stroke / death rates are the result of the use of the following treatment strategies: no anticoagulation with vitamin-k-antagonists (VKAs) or novel oral anticoagulants (NOACs), anticoagulation with VKAs and anticoagulation with NOACs (all). What other thromboembolic complication rates resulting from the use of these treatment strategies? What heavy bleeding rates resulting from the defined management strategies? The analysis is based on a data set of patients with atrial fibrillation (AF)(01/01/2010 - 30/06/2014). 2010 is used as the reference period and 01/01/2011-30/06/2013 as the inclusion period. The minimum observation time per patient is 12 months.
Used is a data base of the AOK PLUS as well as the AOK Baden-Württemberg and AOK Bayern.
The aim of the study is to compare clinical outcomes between the different treatment strategies (frequency of events and time to first event). The influence of alternative treatment strategies is measured on the basis of three different methodological approaches: unadjusted comparison of event council and time to first event between the defined patient groups; matched-pair comparison (propensity score matching) between the different groups of patients (treatment strategies) and multivariate analysis using time to event (Cox proportional hazards model) as the dependent variable.

Conditions

Interventions

  • Vitamin-k-antagonists Drug
    ARM 1: Kind: Experimental
    Label: Anticoagulation with vitamin-k-antagonists
    Description: The patient should be treated stable during the observation period with vitamin-k-antagonists (at least one prescription per half-year). The patient should be not been around on other anticoagulants during the observation period. This means that no prescriptions of novel anticoagulants and not more than 30 days should be observable prescriptions of low molecular weight heparins/Clopidogrel per year.
  • Novel oral anticoagulants Drug
    ARM 1: Kind: Experimental
    Label: Anticoagulation with novel oral anticoagulants
    Description: The patient should be treated stable during the observation period with a novel anticoagulant (at least one prescription per half-year). This means that no vitamin-k-antagonists prescriptions and not more than 30 days should be observable prescriptions of low molecular weight heparins/Clopidogrel per year from the start of the observation period.

Trial Design

  • Observation: Cohort
  • Perspective: Retrospective
  • Sampling: Non-Probability Sample

Trial Population

The analysis is based on a data set of patients with atrial fibrillation (01/01/2010 - 30/06/2014) insured by the AOK PLUS, AOK Bayern or AOK Baden-Württemberg.

Outcomes

Type Measure Time Frame Safety Issue
Primary Death 01/01/2011-30/06/2014; at least 12 months; up to 40 months No
Primary Transient ischemic attack 01/01/2011-30/06/2014; at least 12 months; up to 40 months No
Primary Ischemic stroke 01/01/2011-30/06/2014; at least 12 months; up to 40 months No
Primary Hemorrhagic stroke 01/01/2011-30/06/2014; at least 12 months; up to 40 months Yes
Primary Heavy bleeding 01/01/2011-30/06/2014; at least 12 months; up to 40 months Yes

Sponsors