Use of Novel oral anticoagulants (NOACs) in patients with risk of stroke in non valvular Atrial Fibrillation (AF)

Background: Warfarin was used for decades to prevent stroke in high risk AF patients, recent guidelines and published data is recommending use of NOACs like Rivaroxaban as an alternative to Warfarin, Its use is increasing world over because of its predictable action, less food and drug interaction and no need of monitoring for dose adjustments, considering these facts we planned to conduct a study to see the frequency of use of Rivaroxaban in our local population of AF patients with risk of stroke calculated by CHA2DS2-VASc score. Method: This cross-sectional study was done at National Institute of Cardiovascular disease (NICVD) from May 2017 to September 2017 included 137 non-valvular AF patients with high risk of stroke calculated by applying CHA2DS2-VASc score more than or equal to 2. Clinical details and information about anticoagulant medications prescribed to them was also obtained. SPSS 19 was used for the analysis, descriptive statistics such as mean ±SD, frequency and percentages were calculated. Z-test, t-test, and chi-square test were used for the assessment and comparison of data. Two sided p-value of 0.05 was considered for statistical significance. Results: Total 137 patient were included 50.4% (69) were male, 104 (75.91%) out of 137 were on Anticoagulant therapy, with 86 (62.77%) were on Warfarin and only 18 (13.14%) were taking Rivaroxaban. Conclusion: Our study showed very small percentage of non valvular AF patients with risk of stroke were prescribed Rivaroxaban. It's important to update our treating Physicians about this novel agent which is shown to be equally effective and safe in comparison to warfarin, and easy to prescribe without monitoring to reduce stroke risk.