Interventions needed to improve prescription rates of oral anticoagulant for newly diagnosed AF

There is a concerning disparity between stroke risk and oral anticoagulant (OAC) prescription rates among newly diagnosed atrial fibrillation (AF) patients, according to a new analysis that suggests that patient characteristics such as sex, race, comorbidities, and additional prescriptions play a significant role in determining the likelihood of receiving OACs.

A retrospective analysis was conducted on a cohort of 18,404 patients who had received a new diagnosis of AF. Stroke risk was assessed using the CHA2DS2-VASc score.

Among patients at high risk for stroke, only 41.3% received a prescription for an OAC within 6 months of diagnosis.

The study also aimed to identify factors associated with the prescription of OACs. Logistic regression analysis was conducted on 17 independent variables, and several noteworthy associations were observed. Factors positively associated with receiving an OAC prescription included male sex, Caucasian ethnicity (compared to African American), a history of stroke, obesity, congestive heart failure, vascular disorders, and the prescription of current antiplatelet, beta blocker, or calcium channel blocker medications. Additionally, an increasing CHA2DS2-VASc score, indicating a higher stroke risk, was associated with a greater likelihood of receiving an OAC.

Certain factors, including anemia, renal dysfunction, liver dysfunction, the use of antiarrhythmic drugs, and an increasing HAS-BLED score, were negatively associated with the prescription of OACs.

Reference
Manning E, Burns K, Laurie M, Patten L, Ho M, Sandhu A. Factors associated with oral anticoagulant prescription status among patients with a new diagnosis of atrial fibrillation. Clin Cardiol. 2023;doi: 10.1002/clc.24077. Epub ahead of print. PMID: 37401357.