{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:05:19Z","timestamp":1780463119357,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022274","name":"Daiichi Sankyo Europe","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022274","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Edoxaban is a non-vitamin K antagonist oral anticoagulant indicated in patients with non-valvular atrial fibrillation to prevent stroke and systemic embolism. The objective was to obtain real-world data on the safety and effectiveness of edoxaban in routine care among patients with atrial fibrillation. Methods: ETNA-AF-Europe was a multinational, multicenter, prospective, post-authorization observational study. Its objectives were to assess the real-world safety of edoxaban (bleeding events and mortality) and its effectiveness by evaluating stroke, systemic embolic events, and cardiovascular events over 4 years. This article presents the results for Spain and Portugal. Results: In Spain and Portugal, 931 patients were included in the full analysis set. At baseline, 75.3% of patients were receiving edoxaban 60 mg, and 23.3% were receiving edoxaban 30 mg. Participants receiving 30 mg were older, more likely to be frail, and had a higher prevalence of comorbidities. The annualized rates of all-cause death (8.1% vs. 2.5%) and CV death (2.9% vs. 1.2%) were higher in patients receiving 30 mg than in patients receiving 60 mg. The annualized rates of bleeding events and stroke were higher in patients receiving edoxaban 30 mg. Conclusions: The results obtained in clinical practice verified the long-term effectiveness and safety of edoxaban, with low annualized event rates. The differences in outcomes according to edoxaban dose may be attributable to the underlying indication associated with each dose level and to clinical differences between patients.<\/jats:p>","DOI":"10.3390\/jcm15114085","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T14:10:22Z","timestamp":1779718222000},"page":"4085","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Edoxaban for Stroke Prevention in Atrial Fibrillation in Spain and Portugal: 4-Year Follow-Up of the Observational ETNA-AF-Europe Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9103-4753","authenticated-orcid":false,"given":"Gonzalo","family":"Bar\u00f3n-Esquivias","sequence":"first","affiliation":[{"name":"Cardiology Department, Virgen del Roc\u00edo University Hospital, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-207X","authenticated-orcid":false,"given":"Pedro","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Coimbra University Hospital and Medical School, 3046-853 Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5163-6975","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"Santiago-Ruiz","sequence":"additional","affiliation":[{"name":"Medical Department, Daiichi Sankyo Spain, 28045 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Basterra-Trincado","sequence":"additional","affiliation":[{"name":"Medical Department, Daiichi Sankyo Spain, 28045 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds","family":"Vieira dos Santos","sequence":"additional","affiliation":[{"name":"Medical Department, Daiichi Sankyo Portugal, 2740-257 Porto Salvo, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Ruivo","sequence":"additional","affiliation":[{"name":"Medical Department, Daiichi Sankyo Portugal, 2740-257 Porto Salvo, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4249-0684","authenticated-orcid":false,"given":"Eva-Maria","family":"Fronk","sequence":"additional","affiliation":[{"name":"Data and Statistical Sciences\u2014Evidence Generation Department, Daiichi Sankyo, 81379 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-0197","authenticated-orcid":false,"given":"Paulus","family":"Kirchhof","sequence":"additional","affiliation":[{"name":"Cardiology Department, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site North, 20246 Hamburg, Germany"},{"name":"Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-574X","authenticated-orcid":false,"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical, Molecular Pathology and Critical Sciences, University of Pisa, 56126 Pisa, Italy"},{"name":"Cardiovascular Division, Pisa University Hospital, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20132019","volume":"76","author":"Roth","year":"2020","journal-title":"J. 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