Steffel J, Collins R, Antz M, et al. 2021 European heart rhythm association practical guide on the use of non-vitamin k antagonist oral anticoagulants in patients with atrial fibrillation. Europace : Eur Pacing, Arrhythmias, Card Electrophysiol: J Work Groups Card Pacing, Arrhythmias, Card Cell Electrophysiol Eur Soc Cardiol. 2021;23(10):1612–76.

Google Scholar 

Grymonprez M, Simoens C, Steurbaut S, De Backer TL, Lahousse L. Worldwide trends in oral anticoagulant use in patients with atrial fibrillation from 2010 to 2018: a systematic review and meta-analysis. Europace : Eur Pacing, Arrhythmias, Card Electrophysiol: J Work Groups Card Pacing, Arrhythmias, Card Cell Electrophysiol Eur Soc Cardiol. 2022;24(6):887–98.

Google Scholar 

Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51.

Article  CAS  PubMed  Google Scholar 

Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.

Article  CAS  PubMed  Google Scholar 

Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.

Article  CAS  PubMed  Google Scholar 

Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–91.

Article  CAS  PubMed  Google Scholar 

Grymonprez M, De Backer TL, Bertels X, Steurbaut S, Lahousse L. Long-term comparative effectiveness and safety of dabigatran, rivaroxaban, apixaban and edoxaban in patients with atrial fibrillation: A nationwide cohort study. Front Pharmacol. 2023;14:1125576.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Chan YH, See LC, Tu HT, et al. Efficacy and safety of apixaban, dabigatran, rivaroxaban, and warfarin in asians with nonvalvular atrial fibrillation. J Am Heart Assoc. 2018;7(8):e008150. https://doi.org/10.1161/JAHA.117.008150.

Paschke LM, Klimke K, Altiner A, von Stillfried D, Schulz M. Comparing stroke prevention therapy of direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation: a nationwide retrospective observational study. BMC Med. 2020;18(1):254.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Warkentin L, Hueber S, Deiters B, Klohn F, Kühlein T. Vitamin-K-antagonist phenprocoumon versus low-dose direct oral anticoagulants (DOACs) in patients with atrial fibrillation: a real-world analysis of German claims data. Thromb J. 2022;20(1):31.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ujeyl M, Koster I, Wille H, et al. Comparative risks of bleeding, ischemic stroke and mortality with direct oral anticoagulants versus phenprocoumon in patients with atrial fibrillation. Eur J Clin Pharmacol. 2018;74(10):1317–25.

Article  CAS  PubMed  Google Scholar 

Alexander JH, Lopes RD, Thomas L, et al. Apixaban vs. warfarin with concomitant aspirin in patients with atrial fibrillation: insights from the ARISTOTLE trial. Eur Heart J. 2014;35(4):224–32.

Article  CAS  PubMed  Google Scholar 

Dans AL, Connolly SJ, Wallentin L, et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Circulation. 2013;127(5):634–40.

Article  CAS  PubMed  Google Scholar 

Shah R, Hellkamp A, Lokhnygina Y, et al. Use of concomitant aspirin in patients with atrial fibrillation: findings from the ROCKET AF trial. Am Heart J. 2016;179:77–86.

Article  CAS  PubMed  Google Scholar 

Xu H, Ruff CT, Giugliano RP, et al. Concomitant use of single antiplatelet therapy with edoxaban or warfarin in patients with atrial fibrillation: analysis from the ENGAGE AF-TIMI48 Trial. J Am Heart Assoc. 2016;5(2):e002587. https://doi.org/10.1161/JAHA.115.002587.

Yasuda S, Kaikita K, Akao M, et al. Antithrombotic therapy for atrial fibrillation with stable coronary disease. N Engl J Med. 2019;381(12):1103–13.

Article  CAS  PubMed  Google Scholar 

Dewilde WJ, Oirbans T, Verheugt FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet (London, England). 2013;381(9872):1107–15.

Article  CAS  PubMed  Google Scholar 

Lopes RD, Heizer G, Aronson R, et al. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med. 2019;380(16):1509–24.

Article  CAS  PubMed  Google Scholar 

Cannon CP, Bhatt DL, Oldgren J, et al. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N Engl J Med. 2017;377(16):1513–24.

Article  CAS  PubMed  Google Scholar 

Gibson CM, Mehran R, Bode C, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375(25):2423–34.

Article  CAS  PubMed  Google Scholar 

Grymonprez M, Capiau A, Steurbaut S, et al. Adherence and persistence to oral anticoagulants in patients with atrial fibrillation: A Belgian nationwide cohort study. Front Cardiovasc Med. 2022;9:994085.

Article  CAS  PubMed  PubMed Central  Google Scholar 

InterMutualistic Agency (IMA/AIM). Available from: https://ima-aim.be/. Accessed 25 November 2021.

The Minimal Hospital Dataset. Available from: https://www.health.belgium.be/en/node/23607. Accessed 25 November 2021.

The Sectoral Committee of Social Security and Health, Section Health ('Informatieveiligheidscomité'). Available from: https://www.ehealth.fgov.be/ehealthplatform/nl/informatieveiligheidscomite. Accessed 25 November 2021.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet (London, England). 2007;370(9596):1453–7.

Article  Google Scholar 

Hellfritzsch M, Pottegård A, Haastrup SB, Rasmussen L, Grove EL. Cohort selection in register-based studies of direct oral anticoagulant users with atrial fibrillation: an inevitable trade-off between selection bias and misclassification. Basic Clin Pharmacol Toxicol. 2020;127(1):3–5.

Article  CAS  PubMed  Google Scholar 

van Rein N, Heide-Jorgensen U, Lijfering WM, Dekkers OM, Sorensen HT, Cannegieter SC. Major bleeding rates in atrial fibrillation patients on single, dual, or triple antithrombotic therapy. Circulation. 2019;139(6):775–86.

Article  PubMed  Google Scholar 

Zhang Y, Souverein PC, Gardarsdottir H, van den Ham HA, van der Zee AHM, de Boer A. Risk of major bleeding among users of direct oral anticoagulants combined with interacting drugs: a population-based nested case-control study. Br J Clin Pharmacol. 2020;86(6):1150–64.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Holt A, Blanche P, Zareini B, et al. Gastrointestinal bleeding risk following concomitant treatment with oral glucocorticoids in patients on non-vitamin K oral anticoagulants. Heart. 2022;108(8):626–32.

Article  CAS  PubMed  Google Scholar 

Dalgaard F, Mulder H, Wojdyla DM, et al. Patients with atrial fibrillation taking nonsteroidal anti-inflammatory drugs and oral anticoagulants in the ARISTOTLE Trial. Circulation. 2020;141(1):10–20.

Article  CAS  PubMed  Google Scholar 

Holm J, Mannheimer B, Malmström RE, Eliasson E, Lindh JD. Bleeding and thromboembolism due to drug-drug interactions with non-vitamin K antagonist oral anticoagulants-a Swedish, register-based cohort study in atrial fibrillation outpatients. Eur J Clin Pharmacol. 2021;77(3):409–19.

Article  CAS  PubMed  Google Scholar 

Komen JJ, Hjemdahl P, Mantel-Teeuwisse AK, Klungel OH, Wettermark B, Forslund T. Concomitant anticoagulant and antidepressant therapy in atrial fibrillation patients and risk of stroke and bleeding. Clin Pharmacol Ther. 2020;107(1):287–94.

Article  CAS  PubMed  Google Scholar 

Quinn GR, Hellkamp AS, Hankey GJ, et al. Selective serotonin reuptake inhibitors and bleeding risk in anticoagulated patients with atrial fibrillation: an analysis from the ROCKET AF Trial. J Am Heart Assoc. 2018;7(15):e008755.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lee MT, Park KY, Kim MS, You SH, Kang YJ, Jung SY. Concomitant use of NSAIDs or SSRIs with NOACs requires monitoring for bleeding. Yonsei Med J. 2020;61(9):741–9.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kaatz S, Ahmad D, Spyropoulos AC, Schulman S. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost:JTH. 2015;13(11):2119–26.

Article  CAS  PubMed  Google Scholar 

Quan H, Li B, Couris CM, et al. Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. Am J Epidemiol. 2011;173(6):676–82.

Article  PubMed  Google Scholar 

Grymonprez M, Petrovic M, De Backer TL, Steurbaut S, Lahousse L. The impact of polypharmacy on the effectiveness and safety of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Thromb Haemost. 2023. https://doi.org/10.1055/s-0043-1769735.

Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):373–498.

Article  PubMed  Google Scholar 

Capiau A, Mehuys E, De Bolle L, Van Tongelen I, De Backer T, Boussery K. Drug-drug interactions with direct oral anticoagulants: development of a consensus list for ambulatory care. Int J Clin Pharm. 2023;45(2):364–74.

Article  CAS  PubMed  Google Scholar 

Dentali F, Douketis JD, Lim W, Crowther M. Combined aspirin-oral anticoagulant therapy compared with oral anticoagulant therapy alone among patients at risk for cardiovascu