Abstract 11780: Temporal Trends, Racial and Gender Differences in the Use of Oral Anticoagulation in Medicare Patients With Newly Diagnosed Atrial Fibrillation
Introduction: The novel oral anticoagulants (NOAC’s) have provided convenient anticoagulation alternatives to warfarin for stroke prevention in atrial fibrillation (AF) patients.
Hypothesis: We sought to study the temporal trends and racial/gender differences in the use of anticoagulants in AF patients from 2011 to 2013 in Medicare patients with newly diagnosed AF.
Methods: Medicare claims from January 2010 to December 2013 were used to identify patients ≥66 years of age with newly diagnosed AF during 2011-2013, with no documented AF or anticoagulant use in the prior year. Race was identified from the Beneficiary Summary File. Data regarding initiation of oral anticoagulation within 90 days of AF diagnosis as well as type of anticoagulant were collected. We compared oral anticoagulant use for each year by race and sex.
Results: Of the 755,079 patients with newly diagnosed AF, 85% were white, 6% were black, 5% were Hispanic and 4% were other non-white race. The mean age was 79 years and 58% were females. The proportion of patients receiving anticoagulation within 90 days of AF diagnosis decreased from 45% in 2011 to 40% in 2013. Overall, blacks and Hispanics were less frequently anticoagulated compared to whites (35%, 39% and 45% respectively). Females were also less likely to receive anticoagulation compared to males (45% versus 41% respectively). The use of NOAC’s increased from 27 % of patients who received anticoagulation in 2011 to 44% in 2013. Among anticoagulated patients, blacks and Hispanics were less likely to receive NOACs compared to whites (25% and 30% Vs 36%), and females compared to males (34% vs 36%).
Conclusions: In this retrospective study of Medicare patients with newly diagnosed AF, we noted an increase in the use of NOAC’s from 2011 to 2013, but a decrease in the proportion of patients receiving anticoagulation. This highlights the importance of educating health care providers regarding AF and stroke prevention. Blacks or Hispanics and females were less likely to receive any anticoagulation or anticoagulation by an NOAC, compared to whites and males respectively.
Author Disclosures: R. Kabra: None. M. Vaughan Sarrazin: None.
- © 2016 by American Heart Association, Inc.