Arrhythmias & electrophysiology
East Asian immigration and direct oral anticoagulant dosing for atrial fibrillation: A population-based cohort study
Authors' conclusion
EA immigrants were less likely to receive full-dose DOACs and had a higher bleeding hazard, similar stroke hazard, and lower mortality risk than non-EA immigrants. There was no evidence that DOAC dosing had a differential treatment effect in EA immigrants.
Study context
- Population
- Ontario immigrants with atrial fibrillation (AF) aged ≥66 years dispensed DOACs, 2012–20193,958 (27.4%) born in East Asian (EA)
- Participants
- 14,421 participants
- Exposure
- EA-born vs non-EA-born immigrants
- EAn = 3,958
- Outcome
- DOAC dosing (full dose) and outcomes (stroke, bleeding, death)
Methodological detailsadministrative databases
- Administrative databases
Main finding
As reported in the abstract
EA vs Non-EAEstimate (95% CI)P value
Receiving full-dose DOAC
OR 0.64(0.58–0.69)
P < 0.001Composite hospitalization for stroke or bleeding
HR 0.97(0.84–1.12)
P = 0.67Hospitalization for stroke
HR 0.86(0.71–1.04)
P = 0.13Bleeding
HR 1.15(1.02–1.30)
P = 0.02Mortality
HR 0.91(0.84–0.99)
P = 0.04Observational data: associations, not effects.
Further findings
Interaction between EA birth and DOAC dosing
- No significant interaction for stroke
- P = 0.41
- No significant interaction for bleeding
- P = 0.27
- No significant interaction for death
- P = 0.33
Safety
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Bleeding | 1.15 (1.02–1.30) | P = 0.02 | |
| 0.512Hazard ratio (log scale) |
Original publication
East Asian immigration and direct oral anticoagulant dosing for atrial fibrillation: A population-based cohort study. Heart Rhythm. Published 22 May 2025. doi:10.
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