ArticleAmerican journal of cardiovascular drugs : drugs, devices, and other interventions2020
Adherence to Anticoagulation and Risk of Stroke Among Medicare Beneficiaries Newly Diagnosed with Atrial Fibrillation.
Article in American journal of cardiovascular drugs : drugs, devices, and other interventions, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 32 citations in OpenAlex.
- Article
- Angiotensin II-stimulating versus inhibiting antihypertensives and risk of dementia: a nested case-control study using Australian general practice data.Scientific reports · 2026Article
- Article
- The importance and challenge of comparing stroke care, utilization and outcomes in Medicare Advantage and Fee-for-Service Medicare: a narrative review and vision for the future.Journal of comparative effectiveness research · 2026Review
- Long-Term Outcomes Following Left Atrial Appendage Occlusion in Medicare Beneficiaries: Outcomes From the National Cardiovascular Data Registry.Journal of the American Heart Association · 2025Article
- COVID-19 Diagnosis, Oral Anticoagulation, and Stroke Risk in Patients with Atrial Fibrillation.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Article
- COVID-19 pandemic and trends in clinical outcomes and medication use for patients with established atrial fibrillation: A nationwide analysis of claims data.American heart journal plus : cardiology research and practice · 2024Article
- Adherence, persistence and switching rates of apixaban, dabigatran and rivaroxaban in non-valvular atrial fibrillation: a multicentre real-life analysis at 3 years.European journal of hospital pharmacy : science and practice · 2024Article
- COVID-19 pandemic and initiation of treatment for atrial fibrillation: a nationwide analysis of claims data.BMC cardiovascular disorders · 2023Article
- Limitations in Contemporary Pharmacological Stroke Prevention Therapies in Atrial Fibrillation: A Descriptive Literature Review.Journal of clinical medicine · 2023Review
- Unintended Consequences of Increased Out-of-Pocket Costs During Medicare Coverage Gap on Anticoagulant Discontinuation and Stroke.Advances in therapy · 2023Article
- Association of New Use of Antihypertensives That Stimulate vs Inhibit Type 2 and 4 Angiotensin II Receptors With Dementia Among Medicare Beneficiaries.JAMA network open · 2023Article
- Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study-The ISNEP Study.Journal of personalized medicine · 2022Article
- Adherence is an optimal factor for maximizing the effective and safe use of oral anticoagulants in patients with atrial fibrillation.Scientific reports · 2022Article
- Comparison of oral anticoagulation use and adherence among Medicare beneficiaries enrolled in stand-alone prescription drug plans vs Medicare Advantage prescription drug plans.Journal of managed care & specialty pharmacy · 2022Article
- Adherence with direct oral anticoagulants in patients with atrial fibrillation: Trends, risk factors, and outcomes.Journal of arrhythmia · 2022Article
- Article
- COVID-19 and Anticoagulation for Atrial Fibrillation: An Analysis of US Nationwide Pharmacy Claims Data.Journal of the American Heart Association · 2021Article
- Primary care provider payment models and adherence to anticoagulation in patients with atrial fibrillation.Journal of managed care & specialty pharmacy · 2021Article
- Long-Term Medication Adherence Trajectories to Direct Oral Anticoagulants and Clinical Outcomes in Patients With Atrial Fibrillation.Journal of the American Heart Association · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
introductionThe objective of this study was to compare the risk of stroke in atrial fibrillation (AF) with adherent use of oral anticoagulation (OAC), non-adherent use, and non-use of OAC.
methodsUsing 2013-2016 Medicare claims data, we identified patients newly diagnosed with AF in 2014-2015 and collected prescriptions filled for OAC in the 12 months after AF diagnosis (n = 39,272). We categorized participants each day into three time-dependent exposures: adherent use (≥ 80% of the previous 30 days covered with OAC), non-adherent use (0-80% covered with OAC), and non-use (0%). We constructed Cox proportional hazards models to estimate the association between time-dependent exposures and time to stroke, adjusting for demographics and clinical characteristics.
resultsThe sample included 39,272 patients. Study participants spent 35.0% of the follow-up period in the adherent use exposure category, 10.9% in the non-adherent category, and 54.0% in the non-use category. OAC adherent use [hazard ratio (HR) 0.62; 95% confidence interval (CI) 0.52-0.74] and non-adherent use (HR 0.74; 95% CI 0.57-0.95) were associated with lower hazards of stroke than non-use. Adherent use of DOAC (HR 0.54; 95% CI 0.42-0.69) and warfarin (HR 0.70; 95% CI 0.56-0.89) was associated with lower risk of stroke than non-use, but the risk of stroke did not statistically differ between DOAC and warfarin adherent use (HR 0.77; 95% CI 0.56-1.04). DISCUSSION: Although adherence to OAC reduces stroke risk by nearly 40%, newly diagnosed AF patients in Medicare adhere to OAC on average only one third of the first year after AF diagnosis.
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