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Frequency and Outcomes of Reduced Dose Non–Vitamin K Antagonist Anticoagulants: Results From ORBIT‐AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II)

Overview of attention for article published in Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, February 2018
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)
  • High Attention Score compared to outputs of the same age and source (97th percentile)

Mentioned by

news
10 news outlets
twitter
64 tweeters
facebook
2 Facebook pages

Citations

dimensions_citation
102 Dimensions

Readers on

mendeley
120 Mendeley
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Title
Frequency and Outcomes of Reduced Dose Non–Vitamin K Antagonist Anticoagulants: Results From ORBIT‐AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II)
Published in
Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, February 2018
DOI 10.1161/jaha.117.007633
Pubmed ID
Authors

Benjamin A. Steinberg, Peter Shrader, Karen Pieper, Laine Thomas, Larry A. Allen, Jack Ansell, Paul S. Chan, Michael D. Ezekowitz, Gregg C. Fonarow, James V. Freeman, Bernard J. Gersh, Peter R. Kowey, Kenneth W. Mahaffey, Gerald V. Naccarelli, James A. Reiffel, Daniel E. Singer, Eric D. Peterson, Jonathan P. Piccini

Abstract

Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for stroke prevention in atrial fibrillation (AF) but require lower doses in certain patients. We sought to describe the frequency, appropriateness (according to Food and Drug Administration labeling), and outcomes of patients prescribed reduced doses of NOACs in community practice. We analyzed data from the ORBIT-AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II) registry, a prospective, national, observational registry of AF patients. Among 7925 AF patients receiving NOACs, we assessed patterns of use of reduced NOAC doses and associated cardiovascular and bleeding outcomes at median follow-up of 1 year. Overall, 6636 patients (84%) received a NOAC at standard dose, which was consistent with US Food and Drug Administration labeling in 6376 (96%). Reduced NOAC dose was prescribed to 1289 (16% overall), which was consistent with Food and Drug Administration labeling in only 555 patients (43%). Compared with those whose NOAC dose was appropriately reduced, patients receiving inappropriate dose reductions were younger (median age 79 versus 84,P<0.0001) and had lower ORBIT bleeding risk scores (26% ≥4 versus 45%,P<0.0001). Compared with those appropriately receiving standard dosing, patients receiving inappropriately reduced-dose NOACs had higher unadjusted rates of thromboembolic events (2.11 versus 1.35 events per 100 patient years, hazard ratio 1.56, 95% confidence interval 0.92-2.67) and death (6.77 versus 2.60, hazard ratio 2.61, 95% confidence interval 1.86-3.67). After adjustment, outcomes were not significantly different but tended to favor patients dosed appropriately. The majority of dose reductions of NOACs in AF are inconsistent with US Food and Drug Administration recommendations. There appear to be opportunities to improve current NOAC dosing in community practice. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01701817.

Twitter Demographics

The data shown below were collected from the profiles of 64 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 120 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 120 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 21 18%
Other 19 16%
Student > Ph. D. Student 18 15%
Student > Master 9 8%
Student > Bachelor 7 6%
Other 19 16%
Unknown 27 23%
Readers by discipline Count As %
Medicine and Dentistry 54 45%
Pharmacology, Toxicology and Pharmaceutical Science 13 11%
Agricultural and Biological Sciences 3 3%
Computer Science 2 2%
Social Sciences 2 2%
Other 7 6%
Unknown 39 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 112. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 March 2018.
All research outputs
#241,688
of 19,101,906 outputs
Outputs from Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease
#282
of 5,883 outputs
Outputs of similar age
#7,154
of 286,729 outputs
Outputs of similar age from Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease
#8
of 244 outputs
Altmetric has tracked 19,101,906 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,883 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 25.1. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 286,729 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 244 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.