Geographic and Racial Variation in Oral Anticoagulant (OAC) Treatment Among Commercially Insured Patients with Non-valvular Atrial Fibrillation (NVAF) in the United States

Fig. 1. Study design. NVAF, non-valvular atrial fibrillation

Fig. 2. Patient disposition. AF, atrial fibrillation; ICD-9-CM, International Classification of Disease, Ninth Revision, Clinical Modification; NVAF, non-valvular atrial fibrillation

Fig. 3. Rate of untreated, direct oral anticoagulant (DOAC)-treated, and warfarin-treated patients with non-valvular atrial fibrillation (NVAF) at high risk of stroke by geographic region and race. Other/unknown geographic region category includes Puerto Rico, Guam, and the Virgin Islands, and unknown or missing categories. Other race category includes Asian or Pacific Islander, Alaskan Native or Native American, other race categories, and unknown or missing categories. The rate for the West geographic region and Black race does not add up to 100% because of rounding. OAC, oral anticoagulant

Fig. 4. Geographic variation of oral anticoagulant-untreated patients with non-valvular atrial fibrillation at high risk of stroke. 3-Digit zip codes with ≥ 10 patients were considered. Heatmaps were generated for the 50 US states and excluded the territories of Puerto Rico, Guam, and the Virgin Islands. White shading represents bodies of water, 3-digit zip codes with < 10 patients, and 3-digit zip codes with missing information on treatment. Patients with missing 3-digit zip codes (n = 969) were not depicted in the static heatmaps because the 3-digit zip code data were not available for inclusion

Fig. 5. Geographic variation of A direct oral anticoagulant (DOAC)-treated and B warfarin-treated patients with non-valvular atrial fibrillation (NVAF) at high risk of stroke. For heatmaps, 3-digit zip codes with ≥ 10 patients were considered. Heatmaps were generated for the 50 US states and excluded the territories of Puerto Rico, Guam, and the Virgin Islands. White shading represents bodies of water, 3-digit zip codes with < 10 patients, and 3-digit zip codes with missing information on treatment. Patients with missing 3-digit zip codes (n = 969) were not depicted in the static heatmaps because the 3-digit zip code data were not available for inclusion

Fig. 6. Geographic variation of oral anticoagulant (OAC)-untreated among a White and b Black patients with non-valvular atrial fibrillation (NVAF) at high risk of stroke. 3-Digit zip codes with ≥ 10 patients were considered. Heatmaps were generated for the 50 US states and excluded the territories of Puerto Rico, Guam, and the Virgin Islands. White shading represents bodies of water, 3-digit zip codes with < 10 patients, and 3-digit zip codes with missing information on treatment. Patients with missing 3-digit zip codes (n = 969) were not depicted in the static heatmaps because the 3-digit zip code data were not available for inclusion

Fig. 7. Geographic variation of direct oral anticoagulant (DOAC) and warfarin treatment among White and Black patients with non-valvular atrial fibrillation (NVAF) at high risk of stroke. 3-Digit zip codes with ≥ 10 patients were considered. Heatmaps were generated for the 50 US states and excluded the territories of Puerto Rico, Guam, and the Virgin Islands. White shading represents bodies of water, 3-digit zip codes with < 10 patients, and 3-digit zip codes with missing information on treatment. Patients with missing 3-digit zip codes (n = 969) were not depicted in the static heatmaps because the 3-digit zip code data were not available for inclusion