Antithrombotic use and bleeding risk in patients with atrial fibrillation: findings from a multipayer analysis. (January 2016)

• Record Type: Journal Article
• Authors: Lang, Kathleen; Federico, Victoria; Patel, Aarti A; Munsell, Michael; Nelson, Winnie W; Owens, Gary; Mody, Samir H; Schein, Jeffery; Menzin, Joseph
• Is Part Of: Journal of comparative effectiveness research. Volume 5:Number 1(2016)
• Page Start: 39
• Page End: 48
• Publication Date: 2016-01
• Subjects: anticoagulants -- atrial fibrillation -- hemorrhage -- outcomes research -- stroke; Medical care -- Research -- Periodicals; Medical care -- Research -- Evaluation -- Periodicals; Medical care -- Decision making -- Periodicals; Evidence-based medicine -- Periodicals; Medicine, Comparative -- Periodicals; 362.1072
• DOI: 10.2217/cer.15.48
• Languages: English
• ISSNs: 2042-6305

Abstract

Aims: To analyze administrative claims data from Medicaid, Medicare and commercial insurance sources to estimate stroke risk, bleeding risk, and the use of antithrombotic treatment in patients with atrial fibrillation (AF).Methods: Included patients were aged ≥18 years with a new or existing diagnosis of AF. Outcomes were assessed over 1 year and included stroke risk (CHADS2 /CHA2 DS2 -VASc score), bleeding risk (ATRIA score) and anticoagulant use.Results : A total of 115, 906 patients with AF met inclusion criteria between six databases. Among patients with high stroke risk (CHADS2 ≥2) and low bleeding risk (ATRIA 0–3), 42–82% did not receive an antithrombotic.Conclusion: Levels of thromboprophylaxis for high-risk AF patients in real-world data differ significantly from current medical guidelines for stroke prevention.