Author + information
- Sean Pokorney,
- Christopher Granger,
- Kevin Anstrom,
- Eva Kline-Rogers,
- Mark Alberts,
- Gerald Naccarelli,
- Peter Berger,
- John A. House,
- Ujjwala Vijapurkar,
- Jennifer Davidson,
- Bimal Shah and
- Elaine Hylek
Background: Oral anticoagulant (OAC) under-treatment for stroke prevention in atrial fibrillation (AF) has been demonstrated. Limited data are available on treatment trends treatment over time, as non-vitamin K antagonists (NOACs) were introduced.
Methods: Included patients from the Premier Health Database (representing 1 in 5 US discharges) were age ≥ 40 years, admitted January 2011 to June 2015 with a primary or secondary AF diagnosis, CHA2DS2-VASc score >2, and length of stay >1 day. Those with a mechanical heart valve, any bleed, major surgery during admission; left against medical advice, hospice, transfer to another acute care facility; or died in-hospital were excluded. The primary measure, assessed quarterly, was OAC use at discharge, defined as OAC the day before or day of discharge.
Results: Among 1,579,456 admissions in 812 US hospitals, OAC use at discharge increased by 2% per year from 42% in 2011 to 50% in 2015, with an increase in NOAC (3% in 2011 to 25% in 2015) and a decrease in warfarin use (Figure). Aspirin with OAC increased from 12% in 2011 to 15% in 2015, while triple therapy remained unchanged (6% in 2011 and 5% in 2015). Median age was 78 (IQR 69-85) years, 53% female, and median CHA2DS2-VASc score was 4 (IQR 3-5).
Conclusions: The proportion of AF patients treated with OAC for stroke prevention increased by 2% per year from 2011 to 2015, however, only 1 in 2 AF patients at risk for stroke were treated with OAC as of 2015. Initiatives to increase guideline directed stroke prevention in AF are needed.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Fibrillatory Arrhythmias: Outcomes With Contemporary Practice
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1110-097
- 2017 American College of Cardiology Foundation