Racial and sex differences in optimizing anticoagulation therapy for patients with atrial fibrillation

Autor: Mark H. Eckman, Ruth Wise, Anthony C. Leonard, Pete Baker, Rob Ireton, Brett M. Harnett, Estrelita Dixon, Bi Awosika, Chika Ezigbo, Matthew L. Flaherty, Adeboye Adejare, Carol Knochelmann, Rachael Mardis, Sharon Wright, Ashish Gummadi, Richard Becker, Daniel P. Schauer, Alexandru Costea, Dawn Kleindorfer, Heidi Sucharew, Amy Costanzo, Lora Anderson, John Kues
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: American Heart Journal Plus, Vol 18, Iss , Pp 100170- (2022)
Druh dokumentu: article
ISSN: 2666-6022
DOI: 10.1016/j.ahjo.2022.100170
Popis: Study objective: Atrial fibrillation (AF) is the most common cardiac rhythm disorder, responsible for 15 % of strokes in the United States. Studies continue to document underuse of anticoagulation therapy in minority populations and women. Our objective was to compare the proportion of AF patients by race and sex who were receiving non-optimal anticoagulation as determined by an Atrial Fibrillation Decision Support Tool (AFDST). Design, setting, and participants: Retrospective cohort study including 14,942 patients within University of Cincinnati Health Care system. Data were analyzed between November 18, 2020, and November 20, 2021. Main outcomes and measures: Discordance between current therapy and that recommended by the AFDST. Results: In our two-category analysis 6107 (41 %) received non-optimal anticoagulation therapy, defined as current treatment category ≠ AFDST-recommended treatment category. Non-optimal therapy was highest in Black (42 % [n = 712]) and women (42 % [n = 2668]) and lower in White (39 % [n = 4748]) and male (40 % [n = 3439]) patients. Compared with White patients, unadjusted and adjusted odds ratios of receiving non-optimal anticoagulant therapy for Black patients were 1.13; 95 % CI, 1.02–1.30, p = 0.02; and 1.17; 95%CI, 1.04–1.31, p = 0.01; respectively, and 1.10; 95 % CI 1.03–1.18, p = 0.005; and 1.36; 95 % CI, 1.25–1.47, p
Databáze: Directory of Open Access Journals