Objective To retrospectively analyze the change of anticoagulant therapy in hospitalized patients with nonvalvular atrial fibrillation(NVAF)from 2013 to 2020.Methods Four thousand one hundred and thirty-five patients with NVAF discharged from the First Hospital of Fujian Medical University from January 2013 to December 2020 were enrolled,and the patients were divided into 4 groups according to the time period of every 2 years(1 047 patients in the 2013-2014 group,1 036 patients in the 2015-2016 group,1 042 patients in the 2017-2018 group,and 1 010 patients in the 2019-2020 group).The CHA2DS2-VASc[congestive heart failure,hypertension,age≥75(doubled),diabetes mellitus,stroke(doubled),vascular disease,age 65-74 and sex category(female)]score and HAS-BLED(hypertension,abnormal renal/liver function,stroke,bleeding history or predisposition,labile interna-tional normalized ratio,elderly,drugs/alcohol concomitantly)score were involved in the risk stratification.The rates of anticoagulation,warfarin and new oral anticoagulants(NOACs)use in each group were analyzed.Results In patients at high risk of stroke(men with CHA2DS2-VASc score ≥2 and women with CHA2DS2-VASc score ≥3),the rates of anticoagulation use were 30.23％,38.04％,62.69％,and 76.67％respectively in the year of 2013-2014,2015-2016,2017-2018,2019-2020,showing an increasing trend over time(x2for trend=392.549,P＜0.001).The rates of anticoagulation use in the year of 2013-2014,2015-2016,2017-2018,2019-2020 were 33.70％,41.09％,62.19％,and 65.73％,respectively in patients with HAS-BLED score of ≤2,and which were 20.00％,30.23％,40.54％and 75.29％respectively in patients with HAS-BLED score of ≥3.The rates of anticoagulation use showed an increasing trend over time in patients with high and low risk of bleeding.The propor-tions of using warfarin for anticoagulation in 2013-2014,2015-2016,2017-2018,2019-2020 were 33.05％,36.97％,15.36％,and 4.16％,respectively,and the proportions of using NOACs for anticoagulation were 0,3.67％,46.07％,and 62.38％,respectively.The median time in target range(TTR)for international normalized ratio(INR)(target:2-3)in patients taking warfarin was 38.0％(20.0％,50.0％),and only 11.55％of patients had a TTR of 65％or more.Conclusions The rate of anticoagulation therapy for patients with high risk of stroke has in-creased over time,but falls short of guideline recommendations.The control rate of INR is low in out-patient taking warfarin.The use of warfarin is declining,and NOACs have begun to partially replace warfarin in anticoagulat therapy.
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