University education (OR 1.20; 95% CI 1.05-1.36) and highest income (OR 1.19; 95% CI 1.06-1.33) were associated with higher oral anticoagulant prescribing after stroke compared to lower SES.
Observational (n=12,088)
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Do socioeconomic status, age, and country of birth affect the prescription rate of oral anticoagulants at discharge in patients with first-ever ischemic stroke and atrial fibrillation?
Significant socioeconomic and demographic inequalities exist in the prescription of oral anticoagulants for secondary stroke prevention in patients with atrial fibrillation.
Estimación del efecto: OR 1.20 (education); OR 1.19 (income) (95% CI 1.05-1.36 (education); 1.06-1.33 (income))
BACKGROUND AND PURPOSE: Oral anticoagulants (OACs) are effective against ischemic stroke in patients with atrial fibrillation. Our aim was to investigate differences in the prescribing of OACs after ischemic stroke in patients with atrial fibrillation based on age, sex, country of birth, and socioeconomic status. METHODS: Patients with first-ever ischemic stroke and atrial fibrillation without OAC treatment were included from the Swedish stroke register from 2009 to 2012. The outcome was OAC prescribed at discharge. Income, education, country of birth, and risk factors were obtained from official registers. Risk factors and health status were controlled for in multivariable logistic regression. RESULTS: Of 12 088 stroke patients, 36.3% were prescribed an OAC. Prescribing was less common with older age and, in patients born in other Nordic countries (odds ratio OR, 0.82; 95% confidence interval CI, 0.68-0.98) or countries outside of Europe (OR, 0.65; 95% CI, 0.42-0.99) compared with those born in Sweden. University education (OR, 1.20; 95% CI, 1.05-1.36) and highest income (OR, 1.19; 95% CI, 1.06-1.33) were associated with higher levels of OAC prescribing compared with those with primary school education or lowest income level. CONCLUSION: Differences by age, income, education, and country of birth were found in the prescribing of OACs after stroke. Differences were not explained by common risk factors. This indicates socioeconomic inequalities in the prescribing of preventive treatment after stroke.
Sjölander et al. (Wed,) conducted a observational in First-ever ischemic stroke and atrial fibrillation (n=12,088). University education and highest income vs. Primary school education or lowest income level was evaluated on Oral anticoagulant prescribed at discharge (OR 1.20 (education); OR 1.19 (income), 95% CI 1.05-1.36 (education); 1.06-1.33 (income)). University education (OR 1.20; 95% CI 1.05-1.36) and highest income (OR 1.19; 95% CI 1.06-1.33) were associated with higher oral anticoagulant prescribing after stroke compared to lower SES.