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Changes in Oral Anticoagulant Prescribing for Stroke Prevention in Patients With Atrial Fibrillation

Admassie, E, Chalmers, L and Bereznicki, LR ORCID: 0000-0003-3974-3437 2017 , 'Changes in Oral Anticoagulant Prescribing for Stroke Prevention in Patients With Atrial Fibrillation' , The American Journal of Cardiology, vol. 120, no. 7 , pp. 1133-1138 , doi: 10.1016/j.amjcard.2017.06.055.

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Abstract

Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively. Overall, 2,118 patients met our inclusion criteria. The overall rate of anticoagulation increased from 52.5% in the pre-DOAC era to 60.7% in the post-DOAC era (p 2DS2-VASc ≥2 (OR 1.95, 95% CI 1.36 to 2.80) were independent predictors of OAC prescribing in both eras and the whole study period. Conversely, aging and previous bleeding were inversely associated with OAC prescribing. In conclusion, there has been a significant increase in OAC prescribing in the post-DOAC era, potentially driven by the widespread availability of DOACs. However, OAC underuse in high-risk patients and overuse in low-risk patients was apparent throughout our study. These findings highlight the need to identify the drivers of anticoagulant underuse and overuse and address them accordingly.

Item Type: Article
Authors/Creators:Admassie, E and Chalmers, L and Bereznicki, LR
Keywords: AF, stroke, elderly
Journal or Publication Title: The American Journal of Cardiology
Publisher: Excerpta Medica Inc
ISSN: 0002-9149
DOI / ID Number: 10.1016/j.amjcard.2017.06.055
Copyright Information:

Copyright 2017 Elsevier Inc.

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