Key result
Asian and Black patients linked to up to ~18% lower anticoagulation initiation versus White patients.
Why the study?
Anticoagulation reduces stroke risk in atrial fibrillation, yet studies show it is underprescribed in racial/ethnic minority patients.
Does racial/ethnic minority status reduce the likelihood of initiating anticoagulant therapy in patients with incident atrial fibrillation?
Population
111 666 patients in the VA system with incident atrial fibrillation
Comparison
Anticoagulant therapy initiation compared across race/ethnicity groups
Design
Retrospective cohort study
Follow-up
90 days
Authors
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Racial disparities in AF anticoagulation initiation warrant monitoring; leaves open effective strategies to achieve equity in VA care.
Cohort (n=111,666)
Yes
Does racial/ethnic minority status reduce the likelihood of initiating anticoagulant therapy in patients with incident atrial fibrillation?
Effect estimate: aOR 0.90 (95% CI 0.85-0.95)
Absolute Event Rate: 60.3% vs 62.7%
p-value: p=<.001
Significant racial and ethnic disparities exist in the initiation of any anticoagulation and the use of direct-acting oral anticoagulants for incident atrial fibrillation within the VA healthcare system.
Essien et al. (2021) conducted a cohort in Incident atrial fibrillation (n=111,666). Racial/ethnic minority status vs. White patients was evaluated on Initiation of any anticoagulation within 90 days of an index atrial fibrillation diagnosis (aOR 0.90, 95% CI 0.85-0.95, p=<.001). Compared with White patients, the odds of initiating any anticoagulant therapy were significantly lower for Asian (aOR 0.82; 95% CI 0.72-0.94) and Black (aOR 0.90; 95% CI 0.85-0.95) patients.
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