Arrhythmias & electrophysiology
Temporal trends of prescription rates, oral anticoagulants dose, clinical outcomes, and factors associated with non-anticoagulation in patients with incident atrial fibrillation
Authors' conclusion
There was an increasing trend of OAC prescription, temporally associated with a decreased risk of ischaemic stroke and mortality. Among DOACs users, the risk of ischaemic stroke declined gradually, partly explained by the increasing prescriptions of higher dose DOACs. Both patient and non-patient factors were associated with non-anticoagulation. Further efforts are required to increase OAC prescription.
Study context
- Population
- Patients with newly diagnosed (incident) atrial fibrillation (AF), 1 January 2011–31 December 2020patients with newly diagnosed AF
- Participants
- 249,107 patients
- Comparison
- Temporal trends by year of incident AF diagnosis
- Outcome
- OAC prescription
- Follow-up
- 2011 to 2020
Main finding
As reported in the abstract
Oral anticoagulant (OAC) prescription in 2011
22.1%
OAC prescription in 2020
57.7%
Direct oral anticoagulant (DOAC) share of overall OAC prescriptions
91.0%
Further findings
1-year risks of ischaemic stroke, intracranial haemorrhage (ICH) and all-cause mortality
- Increasing trends for a greater decrease in the risk of ischaemic stroke during 2012-2020 compared to 2011
- Increasing trends for a greater decrease in mortality during 2014-2020 compared to 2011
- Risk of ICH did not change significantly
Higher dose DOAC use among DOAC users · 2012 to 2019-2020
- Higher dose use in 2012
- 11.04%
- Higher dose use in 2019-2020
- 44.29%
- Temporally associated with a lower risk of ischaemic stroke in 2015-2017 and 2018-2020 compared to 2012-2014
Factors associated with non-anticoagulation
- 'Patient-related factors' and 'non-patient' factors (AF diagnosed at clinics by physicians other than cardiologist/neurologist/internal medicine and citizens outside municipalities)
Original publication
Summarised from the published abstract; every number is checked against it