OBJECTIVES: to analyze the pharmacoutilization in patients suffering from non-valvular atrial fibrillation (NVAF), to estimate prevalence and incidence of oral anticoagulants users (VKA and NOACs) or antiplatelet users. METHODS: a retrospective cohort of patients with at least one hospitalization referring to a primary or secondary NVAF diagnosis was extracted from administrative databases of five Italian Local Health Units (Bergamo, Piacenza, Roma, Bussolengo and Palermo) during the period from 1 January 2009 to 31 December 2014. Patients with a heart valve surgery (DRG 104-105) or patients with a hospitalization referring to a primary or secondary diagnosis of mitral and/or aortic valves disease (ICD9 code 394, 395, 396) were excluded from the analysis. All patients receiving at least one prescription of study medication (VKA, NOACs or antiplatelet) during 2014 were followed up for a 12 months period in order to evaluate pharmacoutilization and treatment persistence. RESULTS: Preliminary data regarding Bergamo and Piacenza showed that the cohort was composed of 16098 patients with NVAF and, among them, 11.727 patients (72.9%) were being treated with VKA, NOACs or antiplatelets in 2014. 1809 patients were found to be incident users. Most prescribed treatments were warfarin and acetylsalicylic acid that together cover over the 75% of prevalent patients (50.5% and 28.8% of users, respectively) and over the 60% of incident patients (41.3% and 22.5% of users, respectively). At 12 months, higher persistence was found in incident users treated with apixaban (58.1%), rivaroxaban (49.6%) and dabigatran (46.8%) in comparison with warfarin (15.7%) and acetylsalicylic acid (24.3%). Significant differences were found among NOACs versus VKA and antiplatelets (pvalue < 0.0001). CONCLUSIONS:  Warfarin and acetylsalicylic acid were the most prescribed treatments, but they showed a lower persistence in comparison with NOACs, especially Apixaban.