Once-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may increase patient adherence to treatment but may also be associated with a higher risk of bleeding. In this study, we investigated the adherence to once- or twice-daily dosing of NOACs and the risk of bleeding in nonvalvular atrial fibrillation (NVAF) patients. This multicenter cross-sectional study, conducted between 1 September 2015 and 28 February 2016, included 2214 patients receiving NOACs for at least 3 months, due to NVAF. Patients receiving once-daily or twice-daily NOAC doses were 1:1 propensity score matched for baseline demographic characteristics and the presence of other diseases. The medication adherence was assessed by the 8-item Morisky Medication Adherence Scale. Risk factors were investigated in relation to minor and major bleeding. The mean age of patients was 71 ± 10 years, and 53% of the patients were women. The medication adherence was lower in patients receiving twice-daily NOAC doses compared to once-daily-dose group (47% versus 53%, p = 0.001), and there was no difference between the groups in terms of minor (15% versus 16%, p = 0.292) and major bleeding (3% versus 3%, p = 0.796). Independent risk factors for bleeding were non-adherence to medication (OR: 1.62, 95% CI: 1.23-2.14, p = 0.001), presence of 3 or more other diseases (OR: 10.3, 95% CI: 5.3-20.3, p < 0.001), and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol) score (OR: 4.84, 95% CI: 4.04-5.8, p < 0.001). In summary, the once-daily dose of NOACs was associated with increased patient adherence to medication, while it was not associated with bleeding complications.

中文翻译：

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非维生素K拮抗剂口服抗凝药（NOAC）每日一次或两次给药对非瓣膜性房颤患者的安全性：一项NOAC-TR研究。

每天一次服用非维生素K拮抗剂口服抗凝剂（NOAC）可能会增加患者对治疗的依从性，但也可能与更高的出血风险相关。在这项研究中，我们调查了非瓣膜性房颤（NVAF）患者坚持每天一次或两次服用NOAC的风险以及出血的风险。这项多中心横断面研究于2015年9月1日至2016年2月28日进行，纳入了2214名因NVAF接受NOAC至少3个月的患者。每天接受一次或每天两次NOAC剂量的患者的倾向得分与基线人口统计学特征和其他疾病的存在相匹配，为1：1。药物依从性通过8个项目的Morisky药物依从性量表进行评估。研究了与轻度和重度出血相关的危险因素。患者的平均年龄为71±10岁，其中53％为女性。与每日一次剂量组相比，每天两次使用NOAC剂量的患者的药物依从性较低（47％比53％，p = 0.001），并且两组之间在未成年人方面无差异（15％比16 ％，p = 0.292）和大出血（3％比3％，p = 0.796）。出血的独立危险因素是不坚持用药（OR：1.62，95％CI：1.23-2.14，p = 0.001），存在3种或以上其他疾病（OR：10.3，95％CI：5.3-20.3，p <0.001）和HAS-BLED（高血压，肾和肝功能异常，中风，出血，不稳定INR，老年人，药物或酒精）得分（OR：4.84，95％CI：4.04-5.8，p <0.001）。总而言之，每天一次的NOAC剂量与患者对药物的依从性增加有关，