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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

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@article{ccc112d3e1f8402389006c554552fb7a,
title = "Trends in incidence of oral anticoagulant-related intracerebral hemorrhage and sales of oral anticoagulants in Capital Region of Denmark 2010–2017",
abstract = "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.",
keywords = "direct oral anticoagulants, hemorrhagic stroke, intracerebral hemorrhage, new oral anticoagulants, Non-vitamin K-antagonist oral anticoagulants, vitamin K-antagonists",
author = "Josefine Grundtvig and Christian Ovesen and Inger Havsteen and Thomas Christensen and David Gaist and Iversen, {Helle K.} and Christina Kruuse and Alexander Lilja-Cyron and Karen {\AE}gidius and Sverre Rosenbaum and Per Meden and Jacob Marstrand and Louisa Christensen and Thorsten Steiner and Hanne Christensen",
note = "Funding Information: This work was supported by the Lundbeck Foundation. Publisher Copyright: {\textcopyright} European Stroke Organisation 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jun,
doi = "10.1177/23969873211008770",
language = "English",
volume = "6",
pages = "143--150",
journal = "European Stroke Journal",
issn = "2396-9873",
publisher = "SAGE Publications Inc.",
number = "2",

}

RIS

TY - JOUR

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 - Funding Information: This work was supported by the Lundbeck Foundation. Publisher Copyright: © European Stroke Organisation 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

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

UR - http://www.scopus.com/inward/record.url?scp=85104268265&partnerID=8YFLogxK

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: 66257347