Table 1.
Characteristics of AF patients
| Total (N = 864,339) | OAC Prescription (n = 586,554) | No OAC Prescription (n = 277,785) | P Value | |
|---|---|---|---|---|
| Mean household income (×$1,000) | 69.43 ± 13.15 | 69.50 ± 13.12 | 69.28 ± 13.21 | <.001 |
| Age, y | 73.54 ± 11.43 | 74.48 ± 10.38 | 71.57 ± 13.15 | <.001 |
| Male | 490,102 (57) | 332,949 (57) | 157,153 (57) | .096 |
| Weight, kg | 88.47 ± 24.38 | 89.52 ± 24.68 | 86.23 ± 23.56 | <.001 |
| CHA2DS2-VASc score | 3.60 ± 1.71 | 3.74 ± 1.64 | 3.30 ± 1.81 | <.001 |
| Eligible for OAC∗ | 734,288 (85) | 520,909 (89) | 213,379 (77) | <.001 |
| Race/ethnicity | ||||
| Hispanic | 25,532 (3) | 16,834 (2.9) | 8698 (3.1) | <.001 |
| Non-Hispanic White | 572,814 (66) | 393,402 (67) | 179,412 (65) | |
| Non-Hispanic Black | 37,833 (4.4) | 24,671 (4.2) | 13,162 (4.7) | |
| Other | 13,268 (1.5) | 8864 (1.5) | 4404 (1.6) | |
| Missing | 214,892 (25) | 142,783 (24) | 72,109 (26) | |
| Clinic location | ||||
| West | 161,060 (19) | 111,685 (19) | 49,375 (18) | <.001 |
| Northeast | 182,001 (21) | 124,672 (21) | 57,329 (21) | |
| Midwest | 131,658 (15) | 89,046 (15) | 42,612 (15) | |
| South | 436,030 (50) | 292,118 (50) | 143,912 (52) | |
| Urban | 182,659 (21) | 123,413 (21) | 59,246 (21) | |
| Suburban | 136,431 (16) | 96,446 (16) | 39,985 (14) | |
| Rural | 32,420 (3.8) | 22,109 (3.8) | 10,311 (3.7) | |
| Size of clinic (number of patients) | 19,705.51 ± 16,583.81 | 19,994.35 ± 16,805.25 | 19,095.63 ± 16,089.24 | <.001 |
| Insurance type | ||||
| Private | 500,882 (58) | 340,187 (58) | 160,695 (58) | <.001 |
| Medicaid | 54,517 (6.3) | 35,652 (6.1) | 18,865 (6.8) | |
| Medicare | 526,572 (61) | 375,615 (64) | 150,957 (54) | |
| State | 7839 (0.91) | 5155 (0.88) | 2684 (0.97) | |
| Other | 35,070 (4.1) | 24,250 (4.1) | 10,820 (3.9) | |
| None | 3225 (0.37) | 2147 (0.37) | 1078 (0.39) | |
| Clinic and lab values | ||||
| Heart rate, beats/min | 72.20 ± 13.51 | 72.60 ± 13.72 | 71.41 ± 13.03 | <.001 |
| Systolic BP, mm Hg | 127.97 ± 17.20 | 127.77 ± 17.12 | 128.40 ± 17.37 | <.001 |
| Diastolic BP, mm Hg | 73.57 ± 10.40 | 73.45 ± 10.34 | 73.82 ± 10.52 | <.001 |
| Total cholesterol, mg/dL | 158.82 ± 40.99 | 156.63 ± 39.95 | 163.63 ± 42.81 | <.001 |
| HDL cholesterol, mg/dL | 50.13 ± 16.81 | 49.78 ± 16.61 | 50.90 ± 17.22 | <.001 |
| LDL cholesterol, mg/dL | 86.83 ± 34.65 | 85.40 ± 34.03 | 90.00 ± 35.77 | <.001 |
| Triglyceride, mg/dL | 125.49 ± 70.64 | 125.13 ± 69.96 | 126.27 ± 72.10 | .008 |
| INR | 2.14 ± 2.10 | 2.23 ± 1.97 | 1.75 ± 2.54 | <.001 |
| GFR, mL/min/1.73 m2 | 63.67 ± 22.96 | 62.74 ± 22.16 | 66.11 ± 24.76 | <.001 |
| LVEF, % | 54.98 ± 12.94 | 54.34 ± 13.18 | 56.48 ± 12.23 | <.001 |
| Comorbidities | ||||
| Hypertension | 664,713 (77) | 463,872 (79) | 200,841 (72) | <.001 |
| Dyslipidemia | 517,586 (60) | 360,239 (61) | 157,347 (57) | <.001 |
| Heart failure | 238,781 (28) | 177,488 (30) | 61,293 (22) | <.001 |
| Stable angina | 87,749 (10) | 56,458 (9.6) | 31,291 (11) | <.001 |
| Unstable angina | 26,105 (3) | 15,994 (2.7) | 10,111 (3.6) | <.001 |
| Transient ischemic attack | 56,425 (6.5) | 40,649 (6.9) | 15,776 (5.7) | <.001 |
| Ischemic stroke | 67,588 (7.8) | 48,479 (8.3) | 19,109 (6.9) | <.001 |
| Coronary artery disease | 375,678 (43) | 257,035 (44) | 118,643 (43) | <.001 |
| Myocardial infarction | 55,161 (6.4) | 35,313 (6) | 19,848 (7.1) | <.001 |
| Peripheral artery disease | 99,234 (11) | 68,325 (12) | 30,909 (11) | <.001 |
| Peripheral vascular disease | 74,430 (8.6) | 51,771 (8.8) | 22,659 (8.2) | <.001 |
| Coronary artery bypass grafting | 63,543 (7.4) | 40,949 (7) | 22,594 (8.1) | <.001 |
| Percutaneous coronary intervention | 76,282 (8.8) | 49,994 (8.5) | 26,288 (9.5) | <.001 |
| Type 2 diabetes | 217,996 (25) | 157,247 (27) | 60,749 (22) | <.001 |
| Chronic kidney disease | 89,262 (10) | 63,272 (11) | 25,990 (9.4) | <.001 |
| Chronic liver disease | 90,557 (10) | 63,957 (11) | 26,600 (9.6) | <.001 |
| Hemodialysis | 2370 (0.27) | 1,492 (0.25) | 878 (0.32) | <.001 |
| Kidney transplant | 590 (0.068) | 404 (0.069) | 186 (0.067) | .783 |
| Hyperthyroidism | 8024 (0.93) | 5511 (0.94) | 2513 (0.9) | .117 |
| Hypothyroidism | 55,172 (6.4) | 37,933 (6.5) | 17,239 (6.2) | <.001 |
| Sleep apnea | 82,975 (9.6) | 60,563 (10) | 22,412 (8.1) | <.001 |
| Medications | ||||
| Antiplatelets | 487,204 (56) | 291,608 (50) | 195,596 (70) | <.001 |
| Antiplatelets (without aspirin) | 105,056 (12) | 64,248 (11) | 40,808 (15) | <.001 |
| Antiarrhythmic agents | 327,998 (38) | 253,181 (43) | 74,817 (27) | <.001 |
| Lipid-modifying agents | 533,753 (62) | 390,012 (66) | 143,741 (52) | <.001 |
| Blood glucose regulation agents | 167,735 (19) | 126,588 (22) | 41,147 (15) | <.001 |
| Antihypertensives | 775,798 (90) | 553,571 (94) | 222,227 (80) | <.001 |
| Aspirin | 464,821 (54) | 276,320 (47) | 188,501 (68) | <.001 |
| Prasugrel | 6409 (0.74) | 4232 (0.72) | 2177 (0.78) | .002 |
| Ticagrelor | 7104 (0.82) | 4249 (0.72) | 2855 (1) | <.001 |
| Clopidogrel | 97,316 (11) | 59,874 (10) | 37,442 (13) | <.001 |
| Vorapaxar | 78 (0.009) | 34 (0.0058) | 44 (0.016) | <.001 |
| Anticoagulants | ||||
| Warfarin | 232,538 (27) | 232,538 (40) | — | <.001 |
| Apixaban | 232,720 (27) | 232,720 (40) | — | <.001 |
| Dabigatran | 54,136 (6.3) | 54,136 (9.2) | — | <.001 |
| Rivaroxaban | 147,594 (17) | 147,594 (25) | — | <.001 |
| Edoxaban | 4291 (0.5) | 4291 (0.73) | — | <.001 |
| DOACs | 401,953 (47) | 401,953 (69) | — | <.001 |
Values are mean ± SD or n (%). Patients were stratified by whether they received an OAC prescription.
AF = atrial fibrillation; BP = blood pressure; CHA2DS2-VASc = congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65–74 years, sex category; DOAC = direct oral anticoagulant; GFR = glomerular filtration rate; HDL = high-density lipoprotein; INR = international normalized ratio; LDL = low-density lipoprotein; LVEF = left ventricular ejection fraction; OAC = oral anticoagulation.
∗
Class I indication for OAC was determined by whether a patient had an elevated CHA2DS2-VASc score as specified by contemporary guidelines (CHA2DS2-VASc score ≥2 for men, ≥3 for women).4