ArticleAmerican heart journal2016
Trends in antithrombotic therapy for atrial fibrillation: Data from the Veterans Health Administration Health System.
Article in American heart journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- Elective Hand Surgery and Antithrombotic Use in Veterans.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Stroke in Atrial Fibrillation and Other Atrial Dysrhythmias.Current cardiology reports · 2023Review
- Prescribing Trends of Oral Anticoagulants in US Patients With Cirrhosis and Nonvalvular Atrial Fibrillation.Journal of the American Heart Association · 2023Article
- All-cause mortality trends in patients hospitalized for atrial fibrillation in Sweden: Role of age, stroke risk, and education.International journal of cardiology. Heart & vasculature · 2022Article
- Trends in Atrial Fibrillation Incidence Rates Within an Integrated Health Care Delivery System, 2006 to 2018.JAMA network open · 2020Article
- Guideline-concordant initiation of oral anticoagulant therapy for stroke prevention in older veterans with atrial fibrillation eligible for Medicare Part D.Health services research · 2019Article
- Atrial fibrillation: Stroke prevention in atrial fibrillation: can we do better?Nature reviews. Cardiology · 2016Article
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAlthough controversial, several prior studies have suggested that oral anticoagulants (OACs) are underused in the US atrial fibrillation (AF) population. Appropriate use of OACs is essential because they significantly reduce the risk of stroke in those with AF. In the >2 million Americans with AF, OACs are recommended when the risk of stroke is moderate or high but not when the risk of stroke is low. To quantify trends and guideline adherence, we evaluated OAC use (either warfarin or dabigatran) in a 10-year period in patients with new AF in the Veterans Health Administration.
methodsNew AF was defined as at least 2 clinical encounters documenting AF within 120 days of each other and no previous AF diagnosis (N = 297,611). Congestive Heart Failure, Hypertension, Age > 75, Diabetes, and Stroke (CHADS2) scores were determined using age and diagnoses of hypertension, diabetes, heart failure, and stroke or transient ischemic attack during the 12 months before AF diagnosis. Receipt of an OAC within 90 days of a new diagnosis of AF was evaluated using VA pharmacy data.
resultsOverall, initiation of an OAC fell from 51.3% in 2002 to 43.1% in 2011. For patients with CHADS2 score of 0, 1, 2, 3, 4, and 5-6, the proportions of patients prescribed an OAC showed a relative decrease of 26%, 23%, 14%, 12%, 9%, and 13%, respectively (P < .001). Clopidogrel use was stable at 10% of the AF population.
conclusionsAmong US veterans with new AF and additional risk factors for stroke, only about half receive OAC, and the proportion is declining.
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