Characteristics of patients initiated on edoxaban in Europe: baseline data from edoxaban treatment in routine clinical practice for patients with atrial fibrillation (AF) in Europe (ETNA-AF-Europe)

Research output: Contribution to journalArticle


  • Raffaele De Caterina
  • Peter Kelly
  • Pedro Monteiro
  • Jean Claude Deharo
  • Carlo de Asmundis
  • Esteban López-de-Sá
  • Thomas W Weiss
  • Johannes Waltenberger
  • Jan Steffel
  • Joris R de Groot
  • Pierre Levy
  • Ameet Bakhai
  • Wolfgang Zierhut
  • Petra Laeis
  • Michael Kerschnitzki
  • Paul-Egbert Reimitz
  • Paulus Kirchhof
  • ETNA-AF-Europe investigators

Colleges, School and Institutes

External organisations

  • Università degli Studi di Pisa, Pisa, Italy.
  • HRB Stroke Clinical Trials Network Ireland, University College Dublin, Dublin, Ireland.
  • Hôpital de la Timone, Marseille, France.
  • Universitair Ziekenhuis Brussels, Dilbeek, Belgium.
  • Hospital Universitario La Paz, IDIPAZ, Madrid, Spain.
  • Karl Landsteiner Institute for Cardiometabolics and SFU, Vienna, Austria.
  • University of Munster, Münster, Germany.
  • University Hospital of Zurich, Zürich, Switzerland.
  • Université Paris-Dauphine, PSL Research University, Paris, France.
  • Royal Free London NHS Foundation Trust, Chase Farm Hospital, London, UK.
  • Daiichi Sankyo Europe GmbH, Munich, Germany.
  • Centro Hospitalar e Universitário de Coimbra
  • Amsterdam University Medical Centers/University of Amsterdam


Background: Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have substantially improved anticoagulation therapy for prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). The available routine care data have demonstrated the safety of different NOACs; however, such data for edoxaban are scarce. Here, we report baseline characteristics of 13,638 edoxaban-treated patients with AF enrolled between November 2016 and February 2018.

Methods: ETNA-AF-Europe is a multinational, multi-centre, post-authorisation, observational study conducted in 825 sites in 10 European countries. Patients will be followed up for four years.

Results: Overall, 13,980 patients were enrolled of which 342 patients were excluded from the analysis. Mean patient age was 73.6 years with an average creatinine clearance of 69.4 mL/min. 56.6% were male. The calculated CHA2DS2-VASc and HAS-BLED mean scores were 3.1 and 2.6, respectively. Overall, 3.3, 14.6 and 82.0% of patients had low (CHA2DS2-VASc = 0), intermediate (CHA2DS2-VASc = 1) and high (CHA2DS2-VASc≥2) risks of stroke, respectively. High-risk patients (those with prior stroke, prior major bleeding, prior intracranial bleed or CHA2DS2-VASc ≥4) comprised 38.4% of the overall population. For 75.1% of patients edoxaban was their first anticoagulant prescription, whilst 16.9% switched from a VKA and 8.0% from another NOAC. A total of 23.4% of patients in ETNA-AF-Europe received the reduced dose of edoxaban 30 mg. Overall, 83.8% of patients received an edoxaban dose in line with the criteria outlined in the label.

Conclusion: Edoxaban was predominantly initiated in older, often anticoagulation-naïve, unselected European patients with AF, with a good overall adherence to the approved label.

Trial registration: NCT02944019; Date of registration: October 24, 2016.


Original languageEnglish
Article number165
Number of pages11
JournalBMC Cardiovascular Disorders
Publication statusPublished - 12 Jul 2019


  • Non-vitamin K antagonist oral anticoagulants, Real-world, Registry, Stroke prevention, Major bleeding, Safety outcomes