Evidence map›Paper›PMID 34677571›Full record

ArticleEuropean heart journal. Quality of care & clinical outcomes2022

The effect of mental health conditions on the use of oral anticoagulation therapy in patients with atrial fibrillation: the FinACAF study.

Jussi Jaakkola, Konsta Teppo, Fausto Biancari, Olli Halminen, Jukka Putaala, Pirjo Mustonen, Jari Haukka, Miika Linna, Janne Kinnunen, Paula Tiili and 4 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European heart journal. Quality of care & clinical outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

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  9. Trends in treatment and outcomes of atrial fibrillation during 2007-17 in Finland.European heart journal. Quality of care & clinical outcomes · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Jussi JaakkolaHeart Center, Turku University Hospital, and University of Turku, Hämeentie 11, Turku, Finland.ORCID 0000-0002-3398-4283
Konsta TeppoHeart Center, Turku University Hospital, and University of Turku, Hämeentie 11, Turku, Finland.
Fausto BiancariHeart and Lung Center, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.ORCID 0000-0001-5028-8186
Olli HalminenDepartment of Industrial Engineering and Management, Aalto University, Espoo, Finland.
Jukka PutaalaDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
Pirjo MustonenHeart Center, Turku University Hospital, and University of Turku, Hämeentie 11, Turku, Finland.
Jari HaukkaDepartment of Population Health, University of Helsinki, Yliopistonkatu 4, Helsinki, Finland.
Miika LinnaDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
Janne KinnunenDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
Paula TiiliDepartment of Neurology, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
Aapo L AroHeart and Lung Center, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
Juha HartikainenHeart Center, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio, Finland.ORCID 0000-0003-0847-107X
K E Juhani AiraksinenHeart Center, Turku University Hospital, and University of Turku, Hämeentie 11, Turku, Finland.
Mika LehtoHeart and Lung Center, Helsinki University Hospital, and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland.
University of Helsinki · FIUniversity of Turku · FIAalto University · FIKuopio University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsLittle is known about the effects of mental health conditions (MHCs) on the utilization of oral anticoagulation (OAC) therapy in atrial fibrillation (AF) patients. We aimed to assess whether MHCs affect initiation of OAC therapy among AF patients with special focus on non-vitamin K antagonist oral anticoagulants (NOACs). METHODS AND

resultsThe Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) registry included all 239 222 patients diagnosed with incident AF during 2007-18 in Finland identified from national registries covering primary to tertiary care and drug purchases. Patients with previous depression, bipolar disorder, anxiety disorder, or schizophrenia diagnosis or a fulfilled psychiatric medication prescription within the year preceding the AF diagnosis were classified to have any MHC. The main outcome was OAC initiation, defined as first fulfilled OAC prescription after AF diagnosis. The patients' mean age was 72.7 years and 49.8% were female. The prevalence of any MHC was 19.9%. A lower proportion of patients with any MHC compared with those without MHCs were initiated on OAC therapy (64.9% vs. 73.3%, P < 0.001). Any MHC was associated with lower incidence of OAC initiation [adjusted subdistribution hazard ratio (aSHR) 0.867; 95% confidence interval (CI) 0.856-0.880], as were depression (aSHR 0.868; 95% CI 0.856-0.880), bipolar disorder (aSHR 0.838; 95% CI 0.824-0.852), anxiety disorder (aSHR 0.840; 95% CI 0.827-0.854), and schizophrenia (aSHR 0.838; 95% CI 0.824-0.851), during the entire follow-up. Any MHC remained associated with impaired incidence of OAC initiation also in the NOAC era during 2015-18 (aSHR 0.821; 95% CI 0.805-0.837).

conclusionMHCs are common among AF patients, and they are associated with a lower rate of OAC initiation even during the NOAC era.

Indexed as

Atrial FibrillationStrokeAdministration, OralAgedAnticoagulantsFemaleHumansMaleMental HealthAnticoagulantsAnticoagulationAtrial fibrillationDepressionInequalityMental health

Identifiers

PMID34677571
PMCPMC9071518
OpenAlexW3205696643

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.