Synapse
⌘+K
Synapse
PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
June 1, 2025Journal of Innovations in Cardiac Rhythm ManagementOpen Access

Racial/Ethnic Disparities in Anticoagulation for Atrial Fibrillation by Sex and Within High and Low Stroke Risk Populations

View Full Paper
Ask AI
Bookmark
Share

Comparison

OAC use compared across racial/ethnic groups, sex, and stroke risk populations

Authors

WTWilliam J. TateGHGrace HaJAJames Alzate

Discussion

Loading...

Member takes

Overview

Should not change OAC practice yet; leaves open whether equity interventions can close underuse gaps in high-risk Black patients and Black women.

Structured PICO

P
Population
108,999 adults (ages 18-110) with atrial fibrillation, median age 75, 58.6% male, from the Mass General Brigham Hospital system (US-based). Key demographics: 92.9% White, 2.5% Black, 2.9% Hispanic, 1.7% Asian.
O
Outcome
Rate of oral anticoagulant (OAC) prescription (defined as an active order for warfarin, apixaban, rivaroxaban, dabigatran, or edoxaban)

Black, Hispanic, and Asian individuals, as well as women (particularly Black women), are significantly less likely to be prescribed oral anticoagulants for atrial fibrillation compared to White men, highlighting persistent racial and sex disparities in stroke prevention.

Limitations

  • Data came from a single hospital system (Mass General Brigham), raising concerns about generalizability and potential selection bias
  • Unable to adjust for socioeconomic factors such as family income, level of education, or zip code demographics
  • Reliance on electronic medical record (EMR) data, which may include misdiagnoses of AF due to false-positive or inactive diagnoses
  • Unable to identify patients with other indications for OACs or reduced stroke risk based on prior interventions such as left atrial appendage closure
  • Unable to assess medication adherence, proper medication use, or patient preferences regarding the risks/benefits of anticoagulation

Cite This Study

Tate et al. (2025) studied this question.

synapsesocial.com/papers/6a7f7a51181fd1747d9075e5https://doi.org/10.19102/icrm.2025.16062
View Full Paper
Ask AI
Bookmark
Share