ArticlePharmacotherapy2018
Trends and Variation in Oral Anticoagulant Choice in Patients with Atrial Fibrillation, 2010-2017.
Article in Pharmacotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 5 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
118 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2024Guideline
- Guideline
- Potentially inappropriate prescribing in multimorbid and polymedicated older adults with AF: A Systematic Review and Meta-Analysis.Drugs & aging · 2024Pooled it
- Pooled it
- Pooled it
- Thromboembolic and Hemorrhagic Outcomes in the Direct Oral Anticoagulant Trials Across the Spectrum of Kidney Function.Clinical pharmacology and therapeutics · 2021Trial
- Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial.BMC family practice · 2020Trial
- Appropriateness of prescription of oral anticoagulant therapy in acutely hospitalized older people with atrial fibrillation. Secondary analysis of the SIM-AF cluster randomized clinical trial.British journal of clinical pharmacology · 2019Trial
- Effect of PCC on thrombin generation in patients on FXaI with bleeding or needing urgent surgery (GAUGE).Blood advances · 2026Observational
- Development and validation of a method to compare outcomes between switchers and continuers in routine clinical practice.Journal of comparative effectiveness research · 2026Article
- Article
- Association between first anticoagulant prescription and embolic and hemorrhagic events among older adults with atrial fibrillation.Journal of internal medicine · 2026Observational
- Compound adsorption device in pathogen reduction technology removes multiple drugs from plasma components.Transfusion · 2026Article
- Age and gender disparities in oral anticoagulant use: a nine-year nationwide drug utilization analysis.Frontiers in pharmacology · 2026Article
- Predictors of Direct Oral Anticoagulant Use in Northern Italy: A Population-Based Study.Pharmacoepidemiology and drug safety · 2025Article
- Racial disparities and trends in anticoagulant use among ambulatory care patients with atrial fibrillation and atrial flutter in the United States from 2007 to 2019.BMC health services research · 2025Article
- Hospitalization trends for thromboembolic events in atrial fibrillation: A 12-year national analysis.American heart journal plus : cardiology research and practice · 2025Article
- Systemic Anticoagulation at Discharge in Cardiac Surgical Patients With Postoperative Atrial Fibrillation: A Statewide Cohort Study.Annals of thoracic surgery short reports · 2025Article
- APOE ε4 and Risk of Intracranial Hemorrhage in Patients With Atrial Fibrillation Taking Apixaban.JAMA neurology · 2025Article
- Demographic and Socio-Economic Disparities in the Outcomes Among Patients with NVAF Treated with Oral Anticoagulants: A Real-World Evaluation of Medicare Beneficiaries.Journal of clinical medicine · 2025Article
58 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveSince 2010, several non-vitamin K antagonist oral anticoagulants (NOACs) have been brought to the U.S. market, yet little is known regarding their evolving adoption for prophylaxis of atrial fibrillation (AF)-related stroke. We examined temporal trends in choice of oral anticoagulants (OACs) among incident OAC users with AF and its association with patient demographic and clinical characteristics.
methodsWe conducted a serial cross-sectional analysis of medical and pharmacy claims for commercial and Medicare Advantage enrollees in a large, private, U.S. health plan. We identified 112,187 adults with nonvalvular AF starting OACs between October 2010 and March 2017. Multivariable logistic regression was used to examine the associations of patient characteristics with prescription of NOACs versus warfarin. Multinomial logistic regression was used to test the associations of patient characteristics with choice among NOACs.
resultsThe prescription of NOACs has increased dramatically since their introduction in October 2010. In the first quarter of 2017 (2017Q1), 7502 patients started OACs, of whom 78.9% used NOACs and 21.1% warfarin. For NOACs, 3.8% used dabigatran, 25.0% rivaroxaban, and 50.1% apixaban. In multivariable analyses, factors associated with choice of NOACs versus warfarin included younger age, lower stroke or bleeding risk, fewer comorbidities, higher education level or household net worth, and prescription by cardiologists (all p<0.001). There was no sex difference in likelihood of filling NOACs versus warfarin in 2010Q4-2012, but women had higher odds of starting NOACs (odds ratio = 1.19; 95% confidence interval = 1.14-1.25) in 2015-2017Q1. Among NOAC users, the odds of apixaban prescription increased with age, female sex, stroke or bleeding risk, and comorbidities (all p<0.05).
conclusionNOAC prescriptions have increased substantially among incident OAC users with nonvalvular AF, predominantly driven by increased prescription of apixaban. Warfarin and apixaban were generally preferred for elderly patients, patients with higher stroke or bleeding risk, and patients with more comorbidities.
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