Assessment of NOAC Dosing Patterns in Turkish Patients with Non-Valvular Atrial Fibrillation: A Multicenter, Cross-Sectional Study with Insights from the ASPECT-NOAC Study

OBJECTIVE
We aimed to assess the real‐world label adherence of non‐vitamin K antagonist oral anticoagulant (NOAC) dosing patterns, including apixaban, edoxaban, and rivaroxaban in Turkish patients with atrial fibrillation.

METHODS
This was an observational, prospective, cross-sectional, multicenter study. Patients with AF who were prescribed NOACs within the last 4 months were recruited from 34 cardiology clinics in Turkey. Baseline data were initially collected, and patient awareness was evaluated at 3–4 weeks.

RESULTS
A total of 903 patients were enrolled in the study. The mean age was 72.84 ± 10.17 years. We found that 140 (15.5%), 721 (79.8%), and 42 patients (4.7%) were prescribed off-label low, on-label, and off-label high dosing, respectively. The age of the patients in the on-label group was significantly lower than that of those in the off-label low and off-label high groups (both p<0.001). Female patients were more frequently observed in the off-label high group (p=0.019). The body mass index values of the patients in the off-label high-dose group were significantly lower than those in the other groups (p<0.001). The perception of income levels also revealed significant differences between the groups (p=0.010). Furthermore, the HAS-BLED scores were significantly lower in the on-label group than in the other groups (p<0.001). Similarly, the CHA2DS2-VASc scores were significantly lower in the on-label group than in the off-label group (p<0.001).