{"id":2326,"date":"2021-04-29T00:00:00","date_gmt":"2021-04-29T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/prescribing-of-two-potentially-interacting-cardiovascular-medications-in-atrial-fibrillation-patients-on-direct-oral-anticoagulants\/"},"modified":"2023-06-14T20:03:04","modified_gmt":"2023-06-15T00:03:04","slug":"prescribing-of-two-potentially-interacting-cardiovascular-medications-in-atrial-fibrillation-patients-on-direct-oral-anticoagulants","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/prescribing-of-two-potentially-interacting-cardiovascular-medications-in-atrial-fibrillation-patients-on-direct-oral-anticoagulants\/","title":{"rendered":"Prescribing of two potentially interacting cardiovascular medications in atrial fibrillation patients on direct oral anticoagulants"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; Amiodarone and diltiazem are commonly recommended cardiovascular medications for use in atrial fibrillation (AF) patients. They are known to have drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs). We aimed to evaluate frequency of use of amiodarone or diltiazem among continuous users of DOACs in AF patients and to determine factors associated with their co-use.<\/p>\n<p><strong>Methods <\/strong>&#x2014; The study population included all AF patients with continuous DOAC use in Ontario, Canada, &#x2265;66 years, from April 1, 2017 to March 31, 2018. Concurrent use of amiodarone or diltiazem was determined by identifying the presence of an overlapping prescription. Multivariable logistic regression models were used to identify predictors of amiodarone or diltiazem use.<\/p>\n<p><strong>Results <\/strong>&#x2014; In total, 5,390 AF patients, &#x2265;66 years, with continuous DOAC use were identified. Amiodarone was co-prescribed in 6.4% patients and diltiazem was co-prescribed in 11.2% patients. Prior percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) were associated with significantly increased odds of amiodarone co-use (OR 2.51 [95% CI 1.54, 4.09], p = 0.0002 and OR 5.28 [95% CI 3.52, 7.93], p= &lt;0.001, respectively). Patients with a heart failure (HF) history also had increased co-use of amiodarone (OR 2.05 [95% CI 1.57, 2.67], p &lt; 0.001). The presence of chronic obstructive pulmonary disease (COPD) was associated with significantly increased odds of diltiazem co-use (OR 1.58 [95% CI 1.31, 1.9], p=&lt;0.001).<\/p>\n<p><strong>Conclusions <\/strong>&#x2014; Among AF patients with continuous DOAC use, amiodarone was co-prescribed in 1 in 16 patients and diltiazem was co-prescribed in 1 in 9 patients. Predictors such as history of HF, PCI, CABG or COPD help identify vulnerable populations at increased risk of DDIs.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Amiodarone and diltiazem are commonly recommended cardiovascular medications for use in atrial fibrillation (AF) patients. They are known to have drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs). We aimed to evaluate frequency of use of amiodarone or diltiazem among continuous users of DOACs in AF patients and to determine factors associated with [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2326","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Shurrab M, Koh M, Jackevicius CA, Qiu F, Conlon M, Caswell J, Tu K, Austin PC, Ko DT. <em>Int J Cardiol Heart Vasc<\/em>. 2021; 34:100788. Epub 2021 Apr 29.","source_url":"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8105295\/","ices_scientist":[1281,1146,1385,1189,20901],"site":[6733],"research_program":[6742],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"BC34CA62-9483-4909-ADC3-CBAAAECF3455","sitecore_item_name":"Prescribing-of-two-potentially-interacting-cardiovascular-medications-in-atrial-fibrillation","sitecore_field_values":"{\n  \"Title\": \"Prescribing of two potentially interacting cardiovascular medications in atrial fibrillation patients on direct oral anticoagulants\",\n  \"Short title\": \"Prescribing of two potentially\",\n  \"Summary\": \"This study examined the frequency of use of amiodarone or diltiazem among continuous users of direct oral anticoagulants in atrial fibrillation patients.\",\n  \"Citation\": \"<p>Shurrab M, Koh M, Jackevicius CA, Qiu F, Conlon M, Caswell J, Tu K, Austin PC, Ko DT. <em>Int J Cardiol Heart Vasc<\/em>. 2021; 34:100788. Epub 2021 Apr 29. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.ijcha.2021.100788\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.ijcha.2021.100788<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; Amiodarone and diltiazem are commonly recommended cardiovascular medications for use in atrial fibrillation (AF) patients. They are known to have drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs). We aimed to evaluate frequency of use of amiodarone or diltiazem among continuous users of DOACs in AF patients and to determine factors associated with their co-use.<\/p>n<p><strong>Methods <\/strong>&mdash; The study population included all AF patients with continuous DOAC use in Ontario, Canada, &ge;66 years, from April 1, 2017 to March 31, 2018. Concurrent use of amiodarone or diltiazem was determined by identifying the presence of an overlapping prescription. Multivariable logistic regression models were used to identify predictors of amiodarone or diltiazem use.<\/p>n<p><strong>Results <\/strong>&mdash; In total, 5,390 AF patients, &ge;66 years, with continuous DOAC use were identified. Amiodarone was co-prescribed in 6.4% patients and diltiazem was co-prescribed in 11.2% patients. Prior percutaneous coronary intervention (PCI) and coronary artery bypass surgery (CABG) were associated with significantly increased odds of amiodarone co-use (OR 2.51 [95% CI 1.54, 4.09], p = 0.0002 and OR 5.28 [95% CI 3.52, 7.93], p= &lt;0.001, respectively). Patients with a heart failure (HF) history also had increased co-use of amiodarone (OR 2.05 [95% CI 1.57, 2.67], p &lt; 0.001). The presence of chronic obstructive pulmonary disease (COPD) was associated with significantly increased odds of diltiazem co-use (OR 1.58 [95% CI 1.31, 1.9], p=&lt;0.001).<\/p>n<p><strong>Conclusions <\/strong>&mdash; Among AF patients with continuous DOAC use, amiodarone was co-prescribed in 1 in 16 patients and diltiazem was co-prescribed in 1 in 9 patients. Predictors such as history of HF, PCI, CABG or COPD help identify vulnerable populations at increased risk of DDIs.<\/p>n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8105295\/\" title=\"Opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{BEC72DE0-BA8C-42B8-ACE5-EE29FFB2CB3B}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{BA86E62A-3468-443D-939F-34A9EFA7B7AA}|{B3827152-93D1-4FB2-B106-590CB331A264}|{7D498E8B-5801-4F9E-AC41-11ED50F3C34E}|{38EC2911-02F8-4928-BFEA-973733B7657A}\",\n  \"Posted Date\": \"20210429T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2021\/April\/Prescribing-of-two-potentially-interacting-cardiovascular-medications-in-atrial-fibrillation"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Prescribing of two potentially interacting cardiovascular medications in atrial fibrillation patients on direct oral anticoagulants<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Amiodarone and diltiazem are commonly recommended cardiovascular medications for use in atrial fibrillation (AF) patients. 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