Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(8), 937–941. https://doi.org/10.1002/clc.24077 Dr. Evan Manning et al.
Points
- Atrial fibrillation (AF) is a common arrhythmia that increases the risk of stroke. However, many newly diagnosed AF patients at high risk for stroke do not receive oral anticoagulant (OAC) prescriptions.
- This retrospective study analyzed electronic health record data of 18,404 newly diagnosed AF patients to identify factors associated with OAC prescription rates.
- Only 41.3% of high-risk AF patients received an OAC prescription within six months of diagnosis.
- Factors positively associated with OAC prescription rates included male sex, Caucasian race, history of stroke, obesity, congestive heart failure, vascular disorder, and specific medication prescriptions.
- Factors negatively associated with OAC prescription rates included anemia, renal dysfunction, liver dysfunction, use of antiarrhythmic drugs, and increasing HAS-BLED score.
Summary
A research study was conducted to investigate the prescription rates of oral anticoagulants (OACs) among newly diagnosed atrial fibrillation (AF) patients at high risk for stroke. The study utilized electronic health record data to identify patients who were not anticoagulated and aimed to determine the factors associated with OAC prescription. The study hypothesized that the timely prescription of OACs among patients with newly diagnosed AF is poor.
The study was conducted retrospectively and included 18,404 patients with a new diagnosis of AF. The primary outcome measured was the prescription of an OAC within six months following diagnosis. The stroke risk was assessed using the CHA2DS2-VASc score. Logistic regression analysis was performed to evaluate the odds of being prescribed an OAC for various independent variables.
The results of the study revealed that among patients at high risk for stroke, only 41.3% received an OAC prescription within six months of diagnosis. Several factors were found to be positively associated with receiving an OAC prescription, including male sex, Caucasian race (compared to African American), history of stroke, obesity, congestive heart failure, vascular disorder, and the use of certain medications such as antiplatelets, beta-blockers, and calcium channel blockers. On the other hand, factors such as anemia, renal dysfunction, liver dysfunction, use of antiarrhythmic drugs, and increasing HAS-BLED score were negatively associated with OAC prescription rates.
In conclusion, the study highlights that a significant proportion of newly diagnosed AF patients at high risk for stroke do not receive OAC prescriptions within the first six months following diagnosis. The analysis suggests that patient characteristics such as sex and race, as well as comorbidities and additional medication prescriptions, play a role in the rates of OAC prescribing.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24077
References Manning, E., Burns, K., Laurie, M., Patten, L., Ho, M., & Sandhu, A. (2023). Factors associated with oral anticoagulant prescription status among patients with a new diagnosis of atrial fibrillation. Clinical Cardiology, 46(8), 937–941. https://doi.org/10.1002/clc.24077
