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Arrhythmias & electrophysiologyResearch article

Use of Anticoagulation Among Patients With Atrial Fibrillation or Atrial Flutter in the United States

Circ Popul Health OutcomesPublished

  • Electronic health records study
  • 7 US health systems
  • National Patient-Centered Clinical Research Network
  • 2015–2019
  • multivariable logistic regression
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Authors' conclusion

Among patients with newly diagnosed atrial fibrillation at high risk for ischemic stroke, OAC prescribing at diagnosis was suboptimal, and loss of documented OAC prescribing was common during the first year. Baseline OAC use was more strongly associated with bleeding risk, frailty, and comorbidity burden, and less consistently aligned with ischemic stroke risk.

Study context

Population
Patients with newly diagnosed atrial fibrillation at high risk of ischemic stroke (CHA 2 DS 2 -VASc score ≥2 for men or ≥3 for women)median age, 76 years [interquartile range, 68–82], 70,327 [43.6%] women
Participants
161,295 patients
Comparison
Factors associated with baseline oral anticoagulation (OAC) prescribing and loss of documented OAC prescribing during follow-up
  • Documented baseline OAC prescriptionn = 92,518
  • No documented baseline OAC prescriptionn = 68,777
Outcome
Documented OAC prescription at baseline and during 1-year follow-up
Follow-up
baseline and 1-year follow-up

Main finding

As reported in the abstract

Documented OAC prescription at baseline
92 518 (57.4%)
Baseline OAC prescription in 2015
56.6%
Baseline OAC prescription in 2019
62.6%
Of those with a documented baseline OAC prescription, no documented OAC prescription during 1-year follow-up
45.6%
Of 68 777 patients without a documented baseline OAC prescription, OAC prescription documented during follow-up
12.5%

Further findings

Factors associated with baseline OAC prescribing

Comparisonodds ratio (95% CI)
Dementia · lower odds of baseline OAC prescribing0.58 (0.56–0.61)
Prior major bleeding · lower odds of baseline OAC prescribing0.69 (0.63–0.75)
Renal disease · lower odds of baseline OAC prescribing0.84 (0.81–0.88)
Heart failure · higher odds of baseline OAC prescribing1.40 (1.37–1.43)

Original publication

Use of Anticoagulation Among Patients With Atrial Fibrillation or Atrial Flutter in the United States. Circ Popul Health Outcomes. Published 9 October 2026. doi:10.1161/circoutcomes.126.013494
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Summarised from the published abstract; every number is checked against it