Publication:
Rate and reasons for the use of oral anticoagulants in patients with non-valvular atrial fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 0 in Thailand: The COOL-AF registry

Issued Date

2020-10-01

Resource Type

Article

ISSN

01252208

DOI

10.35755/jmedassocthai.2020.10.11529

Other identifier(s)

2-s2.0-85092789394

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol.103, No.10 (2020), 987-995

Suggested Citation

Komsing Methavigul, Arjbordin Winijkul, Sirin Apiyasawat, Ratikorn Methavigul, Thanasak Patmuk, Pattraporn Srirattana, Praprut Thanakitcharu, Kulyot Jongpiputvanich, Sumon Tangsuntornwiwat, Ahthit Yindeengam, Rungroj Krittayaphong, Tomorn Thongsri, Kriengkrai Hengrussamee, Wattana Wongtheptien, Pornchai Ngamjanyaporn, Arintaya Phrommintikul, Smonporn Boonyaratavej, Pongpun Jittham, Treechada Wisaratapong, Rungroj Krittayaphong, Roj Rojjarekampai, Somchai Dutsadeevettakul, Chaiyasith Wongvipaporn, Thanita Boonyapiphat, Weerapan Wiwatworapan, Khanchai Siriwattana, Thoranis Chantrarat, Kasem Ratanasumawong, Wiwat Kanjanarutjawiwat, Suchart Arunsiriwattana Rate and reasons for the use of oral anticoagulants in patients with non-valvular atrial fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 0 in Thailand: The COOL-AF registry. Journal of the Medical Association of Thailand. Vol.103, No.10 (2020), 987-995. doi:10.35755/jmedassocthai.2020.10.11529 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/60077

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Title

Rate and reasons for the use of oral anticoagulants in patients with non-valvular atrial fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 0 in Thailand: The COOL-AF registry

Author(s)

Komsing Methavigul
 Arjbordin Winijkul
 Sirin Apiyasawat
 Ratikorn Methavigul
 Thanasak Patmuk
 Pattraporn Srirattana
 Praprut Thanakitcharu
 Kulyot Jongpiputvanich
 Sumon Tangsuntornwiwat
 Ahthit Yindeengam
 Rungroj Krittayaphong
 Tomorn Thongsri
 Kriengkrai Hengrussamee
 Wattana Wongtheptien
 Pornchai Ngamjanyaporn
 Arintaya Phrommintikul
 Smonporn Boonyaratavej
 Pongpun Jittham
 Treechada Wisaratapong
 Rungroj Krittayaphong
 Roj Rojjarekampai
 Somchai Dutsadeevettakul
 Chaiyasith Wongvipaporn
 Thanita Boonyapiphat
 Weerapan Wiwatworapan
 Khanchai Siriwattana
 Thoranis Chantrarat
 Kasem Ratanasumawong
 Wiwat Kanjanarutjawiwat
 Suchart Arunsiriwattana

Other Contributor(s)

Udon Thani Center Hospital
 Nakornping Hospital
 Lampang Hospital
 Chonburi Regional Hospital
 Prapokklao Hospital
 Chulalongkorn University
 Police General Hospital
 Naresuan University
 Vajira Hospital
 Khon Kaen University
 Faculty of Medicine, Ramathibodi Hospital, Mahidol University
 Mahidol University
 Thammasat University
 Buddhachinaraj Hospital
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Phramongkutklao College of Medicine
 Prince of Songkla University
 Chiang Mai University
 Ratchaburi Regional Hospital
 Golden Jubilee Medical Center
 Charoenkrungpracharak Hospital
 Sapphasitthiprasong Hospital
 Surat Thani Hospital
 Central Chest Institute of Thailand
 Maharat Nakorn Ratchasima Hospital
 Chiangrai Prachanukroh Hospital

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2020. Background: A substantial number of patients with non-valvular atrial fibrillation (NVAF) and a CHA2DS2-VASc score of 0 (i.e., low-risk group) use oral anticoagulants (OACs). Objective: To investigate the rate and reasons for OAC use in Thai patients with NVAF and having a CHA2DS2-VASc score of 0. Materials and Methods: A nationwide observational multicenter registry of patients with NVAF was set up in Thailand. The patients’ demographic and clinical data were recorded on a case record form and then entered into a web-based data collection and management system. Results: One hundred seventy-six patients with NVAF and a CHA2DS2-VASc score of 0 were included. The average age was 53.9±8.2 years old, and all patients were male. Forty-six (26.1%) of the patients received OACs. NVAF patients receiving OACs had a longer duration of AF, more persistent and permanent AF, and mild left ventricular dysfunction. NVAF patients not receiving OACs were significantly more likely to be taking antiplatelet drugs. The reasons for using OACs in patients with a CHA2DS2-VASc score of 0 included thrombus in the left atrial appendage, post-AF ablation, planned cardioversion, hypertrophic cardiomyopathy, hyperthyroidism, and endomyocardial fibrosis. Physicians or patients preferred OAC use despite having a CHA2DS2-VASc score of 0 in 24 patients (52.2%). The use of OACs did not decrease clinical events, but it increased the bleeding risk. Conclusion: Among Thai NVAF patients with CHA2DS2-VASc score of 0, OAC was used in 26.1%. Some stroke risk factors were identified but were not included in the current risk scoring tool.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/123456789/60077

Collections

Scopus 2020