ArticlePloS one2022
Rural-urban differences in the initiation of oral anticoagulant therapy in patients with incident atrial fibrillation: A Finnish nationwide cohort study.
Article in PloS one, 2022. 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.
- Day-of-the-week variation in ischemic stroke admissions in patients with atrial fibrillation.Annals of medicine · 2026Article
- Temporal Trends in Multimorbidity Patterns in Patients With Atrial Fibrillation-A Nationwide Cohort Study.European journal of clinical investigation · 2026Article
- Venous thromboembolisms and stroke risk in patients with atrial fibrillation: a nationwide cohort study.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 · 2025Article
- Heart Failure and Stroke Risk in Atrial Fibrillation: Temporal Trends From a Nationwide Cohort Study.Journal of the American Heart Association · 2025Article
- Rural-urban and geographical differences in prognosis of atrial fibrillation in Finland: a nationwide cohort study.Scandinavian journal of public health · 2024Article
- Comparing CHAThe Lancet regional health. Europe · 2024Article
- Ischaemic stroke in women with atrial fibrillation: temporal trends and clinical implications.European heart journal · 2024Article
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Authors and funding
14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
aimsLittle is known about rural-urban differences in the treatment and outcomes in patients with atrial fibrillation (AF). We aimed to assess whether the initiation of oral anticoagulant (OAC) therapy in patients with AF differs between those with rural and urban residence.
methodsThe registry-based FinACAF cohort covers all patients with AF from all levels of care in Finland. Patients were divided into rural and urban categories and into urbanization degree tertiles based on their municipality of residence at the time of AF diagnosis. The outcome was the first redeemed OAC prescription.
resultsWe identified 222 419 patients (50.1% female; mean age 72.8 (SD 13.2) years) with incident AF during 2007-2018. Urban residence was associated with a lower rate of OAC therapy initiation (adjusted subdistribution hazard ratio (SHR) (95% CI) 0.96 (0.95-0.97)). Correspondingly, an inverse graded dose-response relationship was observed between higher urbanization degree tertile and OAC initiation rate (highest tertile compared to lowest: adjusted SHR (95% CI) 0.94 (0.93-0.95)). The adoption of direct oral anticoagulants for stroke prevention was faster among patients with urban residence.
conclusionThis nationwide cohort study documented that urban residence is associated with a slightly lower rate of OAC therapy initiation in patients with incident AF, but faster adoption of direct oral anticoagulant use.
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