Key result
One-year OAC persistence in incident AF varies geographically, peaking at ~89% in Norway.
Why the study?
To examine inter-national and regional variations in persistence of oral anticoagulation therapy, incidence of clinical outcomes, and mortality among patients with incident AF in the Nordic countries.
Does geographical location affect persistence to oral anticoagulation therapy and clinical outcomes in patients with incident atrial fibrillation?
Cohort (n=147,501)
Yes
Does geographical location affect persistence to oral anticoagulation therapy and clinical outcomes in patients with incident atrial fibrillation?
There is significant geographical variation in OAC persistence and clinical outcomes among incident AF patients across Nordic countries, highlighting the need for standardized care.
Geographic variation in OAC persistence among incident AF patients should not yet change practice; leaves open whether care standardization improves outcomes.
AIM: To examine inter-national and regional variations in persistence of oral anticoagulation (OAC) therapy and incidence of clinical outcomes and mortality, among patients with incident atrial fibrillation (AF) in the Nordic countries. METHODS: We conducted a registry-based multinational cohort study of OAC-naïve patients diagnosed with AF that redeemed at least one prescription of OAC after AF in Denmark (N = 25 585), Sweden (N = 59 455), Norway (N = 40 046) and Finland (N = 22 415). Persistence was dispensing at least one prescription of OAC from Day 365 after the first prescription and 90 days forward. RESULTS: Persistence was 73.6% (95% confidence interval 73.0-74.1) in Denmark, 71.1% (70.7-71.4) in Sweden, 89.3% (88.2-90.1) in Norway and 68.6% (68.0-69.3) in Finland. One-year risk of ischemic stroke varied between 2.0% (1.8-2.1) in Norway and 1.5% (1.4-1.6) in Sweden and 1.5% (1.3-1.6) in Finland. One-year risk of major bleeding other than intracranial bleeding varied between 2.1% (1.9-2.2) in Norway and 5.9% (5.6-6.2) in Denmark. One-year mortality risk varied between 9.3% (8.9-9.6) in Denmark and 4.2% (4.0-4.4) in Norway. CONCLUSION: In OAC-naïve patients with incident AF, persistence of OAC therapy and clinical outcomes vary across Denmark, Sweden, Norway and Finland. Initiation of real-time efforts are warranted to ensure uniform high-quality care across nations and regions.
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Vinter et al. (2023) conducted a cohort in Incident atrial fibrillation (n=147,501). Oral anticoagulation (OAC) therapy was evaluated on Persistence of oral anticoagulation (OAC) therapy and incidence of clinical outcomes and mortality. One-year persistence to oral anticoagulation therapy among OAC-naïve patients with incident atrial fibrillation varied geographically, ranging from 68.6% in Finland to 89.3% in Norway.
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