Anticoagulant Use in High Stroke-Risk Patients With Nonvalvular Atrial Fibrillation
| Autor: | Jonathan H. Watanabe, Hannah K Nguyen, Daniel G. Blanchard, Douglas Humber, Harvey Checkoway |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty and over Stroke risk 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Atrial Fibrillation 80 and over medicine Humans Medicare Part D Pharmacology (medical) Stroke Retrospective Studies Aged Aged 80 and over 030214 geriatrics business.industry Vascular disease Anticoagulants Atrial fibrillation Retrospective cohort study Middle Aged medicine.disease Geriatrics Heart failure Female business |
| Zdroj: | Nguyen, HK; Humber, D; Checkoway, H; Blanchard, D; & Watanabe, JH. (2018). Anticoagulant Use in High Stroke-Risk Patients With Nonvalvular Atrial Fibrillation.. The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists, 33(9), 521-530. doi: 10.4140/tcp.n.2018.521. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/7pg5897f The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists, vol 33, iss 9 |
| ISSN: | 0888-5109 |
| Popis: | Author(s): Nguyen, Hannah K; Humber, Douglas; Checkoway, Harvey; Blanchard, Daniel; Watanabe, Jonathan H | Abstract: Background Oral anticoagulants (OACs) are recommended for nonvalvular atrial fibrillation (NVAF) patients with moderate-to high-stroke risk. Objective To examine nationally reflective OAC usage in incident NVAF patients longitudinally. Design Three-year retrospective cohort analysis. Setting Medicare Part D recipients in the contiguous United States.Participants52,465 Medicare beneficiaries with incident NVAF in 2010 with two or more atrial fibrillation diagnoses seven or more days apart. Main outcome measure Stroke risk via congestive heart failure, hypertension, age greater than or equal to 75, diabetes, stroke, vascular disease, age 65-74, sex category (CHA2DS2-VASc) score. Primary outcome was proportion of patients receiving one or more OACs post-NVAF diagnoses. Results Of 48,980 high-risk patients, 32.7% received one or more OAC within 60 days of diagnosis. By close of 2011, 48% had one or more OAC. OAC use increased to 52.9% by close of 2012. Conclusions Fewer than 33% of high-risk NVAF patients received OACs within 60 days of diagnosis in 2010. Despite increased use over time, oral anticoagulation was below 53% at study end. Use of OACs declined with CHA2DS2-VASc greater than 6. Expanded efforts are warranted to augment OAC use in high stroke-risk patients. |
| Databáze: | OpenAIRE |
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