Observational studyJournal of thrombosis and thrombolysis2015
Real life anticoagulation treatment of patients with atrial fibrillation in Germany: extent and causes of anticoagulant under-use.
Observational study in Journal of thrombosis and thrombolysis, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Patient Preferences for Oral Anticoagulation Therapy in Atrial Fibrillation: A Systematic Literature Review.The patient · 2017Pooled it
- Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation: a qualitative systematic review.BMC family practice · 2017Pooled it
- Pooled it
- Preferences for anticoagulation therapy in atrial fibrillation: the patients' view.Journal of thrombosis and thrombolysis · 2015Trial
- Article
- Identifying Dementia Severity Among People Living With Dementia Using Administrative Claims Data.Journal of the American Medical Directors Association · 2024Article
- Patient Characteristics Associated With Using Transcatheter Left Atrial Appendage Occlusion Versus Oral Anticoagulants for Atrial Fibrillation.Circulation. Cardiovascular quality and outcomes · 2024Article
- Development and Validation of an Intracranial Hemorrhage Risk Score in Older Adults with Atrial Fibrillation Treated with Oral Anticoagulant.Clinical epidemiology · 2024Article
- Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET/EHRA consensus conference.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Time trends in antithrombotic therapy prescription patterns: Real-world monocentric study in hospitalized patients with atrial fibrillation.World journal of cardiology · 2022Article
- Impact of pre-admission treatment with non-vitamin K oral anticoagulants on stroke severity in patients with acute ischemic stroke.Journal of thrombosis and thrombolysis · 2018Article
- Antiplatelet Prescription in Atrial Fibrillation: Association with a Low Rate of Anticoagulation.TH open : companion journal to thrombosis and haemostasis · 2018Article
- Atrial fibrillation in patients with first-ever stroke: Incidence trends and antithrombotic therapy before the event.PloS one · 2018Article
- Effect of New Oral Anticoagulants on Prescribing Practices for Atrial Fibrillation in Older Adults.Journal of the American Geriatrics Society · 2017Observational
- Persistence with VKA treatment in newly treated atrial fibrillation patients: an analysis based on a large sample of 38,076 German patients.European journal of clinical pharmacology · 2017Article
- Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.JMIR research protocols · 2017Article
- Article
- Antithrombotic prophylaxis of atrial fibrillation in an Italian real-world setting: a retrospective study.Vascular health and risk management · 2017Observational
- Decision-making around antithrombotics for stroke prevention in atrial fibrillation: the health professionals' views.International journal of clinical pharmacy · 2016Article
- Prevalence of Drug Combinations Increasing Bleeding Risk Among Warfarin Users With and Without Alzheimer's Disease.Drugs & aging · 2015Observational
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Oral anticoagulation (OAC) with either new oral anticoagulants (NOACs) or Vitamin-K antagonists (VKAs) is recommended by guidelines for patients with atrial fibrillation (AF) and a moderate to high risk of stroke. Based on a claims-based data set the aim of this study was to quantify the stroke-risk dependent OAC utilization profile of German AF patients and possible causes of OAC under-use. Our claims-based data set was derived from two German statutory health insurance funds for the years 2007-2010. All prevalent AF-patients in the period 2007-2009 were included. The OAC-need in 2010 was assumed whenever a CHADS2- or CHA2DS2-VASC-score was >1 and no factor that disfavored OAC use existed. Causes of OAC under-use were analyzed using multivariate logistic regression. 108,632 AF-prevalent patients met the inclusion criteria. Average age was 75.43 years, average CHA2DS2-VASc-score was 4.38. OAC should have been recommended for 56.1/62.9 % of the patients (regarding factors disfavouring VKA/NOAC use). For 38.88/39.20 % of the patient-days in 2010 we could not observe any coverage by anticoagulants. Dementia of patients (OR 2.656) and general prescription patterns of the treating physician (OR 1.633) were the most important factors increasing the risk of OAC under-use. Patients who had consulted a cardiologist had a lower risk of being under-treated with OAC (OR 0.459). OAC under-use still seems to be one of the major challenges in the real-life treatment of AF patients. Our study confirms that both patient/disease characteristics and treatment environment/general prescribing behaviour of physicians may explain the OAC under-use in AF patients.
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