Arrhythmias & electrophysiology
Trends in Oral Anticoagulant Prescribing for Atrial Fibrillation and Active Cancer in UK Primary Care
Authors' conclusion
In the last decade, OAC initiation has substantially increased among eligible patients with AF and active cancer, driven by direct oral anticoagulant uptake. However, OAC initiation remained lower among patients with lung cancer, metastatic cancer, or specific comorbidities.
Study context
- Population
- Patients aged ≥50 years with incident atrial fibrillation (AF) between 2010 and 2023 and active cancer diagnosed in the year before cohort entry, eligible for oral anticoagulant (OAC) (CHA2DS2-VASc ≥2)
- Participants
- 12,254 eligible patients
- Outcome
- OAC initiation
- Follow-up
- Year following AF diagnosis
Methodological detailsClinical Practice Research Datalink, UK primary care
- Clinical Practice Research Datalink
- UK primary care
Main finding
As reported in the abstract
Patients who initiated an OAC
6,940
56.6%
Observational data: associations, not effects.
Further findings
Per 100 person-years
| Outcome | 2010 | 2023 | Adjusted rate ratio (95% CI) | |
|---|---|---|---|---|
| OAC initiation rate, 2023 vs 2010Driven by increased direct oral anticoagulant prescribing | 89 | 385 | 4.32 (3.78–4.93) | |
| 0.20.5125Adjusted rate ratio (log scale) |
Factors associated with OAC initiation
| Comparison | HR for OAC initiation (95% CI) | |
|---|---|---|
| Lung cancerLess common | 0.74 (0.67–0.82) | |
| Metastatic cancerLess common | 0.66 (0.51–0.87) | |
| DementiaLess common | 0.75 (0.64–0.88) | |
| 0.512HR for OAC initiation (log scale) |
OAC type · 2023
- By 2023, apixaban and edoxaban predominated
Factors associated with OAC initiation
- OAC initiation did not differ by age and sex
Original publication
Trends in Oral Anticoagulant Prescribing for Atrial Fibrillation and Active Cancer in UK Primary Care. JACC Adv. Published 23 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it