Table 3. Determinants of the use of antithrombotic therapies for stroke prevention in AF patients (see also Supplemental Table 2–5).
| Antithrombotic therapy | Univariate analysis (significant variables only) |
Multivariate analysis |
Antithrombotic therapy | Multivariate analysis |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| OAC only | OR | 95%CI | P | OR | 95%CI | P | DAPT | OR | 95%CI | P |
| HASBLED (cont. variable) | 1.08 | 1.01–1.16 | 0.042 | PCI | 4.47 | 2.69–7.43 | <0.001 | |||
| Age≥80 years | 0.62 | 0.50–0.78 | <0.001 | 0.54 | 0.37–0.79 | 0.002 | Coronary artery disease (any) | 9.67 | 5.81–16.10 | <0.001 |
| Hypertension | 1.67 | 1.36–2.05 | <0.001 | 1.85 | 1.30–2.63 | 0.001 | COPD | 1.95 | 1.14–3.33 | 0.015 |
| Prior MI | 0.47 | 0.36–0.61 | <0.001 | 0.58 | 0.37–0.91 | 0.018 | Known history of AF | 0.45 | 0.28–0.72 | 0.001 |
| Prior PCI | 0.32 | 0.22–0.47 | <0.001 | Paroxysmal AF | 2.31 | 1.45–3.69 | <0.001 | |||
| Coronary artery disease (any) | 0.49 | 0.41–0.60 | <0.001 | |||||||
| Stable coronary artery disease | 0.55 | 0.46–0.67 | <0.001 | |||||||
| Mitral valve disease | 1.40 | 1.15–1.70 | 0.001 | 1.56 | 1.07–2.28 | 0.021 | ||||
| Dilated cardiomyopathy | 2.06 | 1.40–3.04 | <0.001 | 1.72 | 1.10–2.68 | 0.018 | Dual or triple therapy | OR | 95%CI | P |
| CKD on dialysis | 0.16 | 0.04–0.60 | 0.007 | Age≥80 years | 0.58 | 0.39–0.88 | 0.009 | |||
| COPD | 0.73 | 0.57–0.94 | 0.016 | PCI | 3.69 | 2.46–5.46 | <0.001 | |||
| Thyroid disease | 1.54 | 1.13–2.11 | 0.007 | Coronary artery disease (any) | 2.78 | 1.94–4.00 | <0.001 | |||
| Known history of AF | 2.53 | 2.07–3.08 | <0.001 | 1.51 | 1.04–2.20 | 0.032 | Hospital–based centre | 2.99 | 1.51–5.91 | 0.002 |
| Paroxysmal AF | 0.38 | 0.32–0.46 | <0.001 | 0.44 | 0.32–0.62 | <0.001 | HASBLED (cont. variable) | 1.24 | 1.11–1.38 | <0.001 |
| Body mass index | 1.06 | 1.04–1.08 | <0.001 | 1.04 | 1.01–1.08 | 0.031 | ||||
| Centre in the capital city | 2.02 | 1.68–2.43 | <0.001 | 2.14 | 1.50–3.05 | <0.001 | ||||
| University centre | 2.09 | 1.62–2.69 | <0.001 | |||||||
| Cardiologist | 1.55 | 1.26–1.92 | <0.001 | |||||||
| Antiplatelet drug only | OR | 95%CI | P | OR | 95%CI | P | OAC (alone or in combination) | OR | 95%CI | P |
| CHA2DS2-VASc (cont. variable) | 1.08 | 1.01–1.16 | 0.021 | HASBLED≥3 | 1.28 | 1.02–1.61 | 0.036 | |||
| Age ≥80 years | 1.88 | 1.42–2.49 | <0.001 | 1.99 | 1.46–2.73 | <0.001 | Hypertension | 1.76 | 1.40–2.22 | <0.001 |
| Coronary artery disease (any) | 1.63 | 1.26–2.10 | <0.001 | 1.35 | 1.03–1.77 | 0.033 | Age≥80 years | 0.52 | 0.39–0.67 | <0.001 |
| Stable coronary artery disease | 1.59 | 1.23–2.07 | <0.001 | Coronary artery disease (any) | 0.74 | 0.60–0.92 | 0.007 | |||
| Aortic valve disease | 2.52 | 1.64–3.86 | <0.001 | 1.52 | 1.06–2.17 | 0.022 | Mitral valve disease | 1.29 | 1.03–1.62 | 0.030 |
| Other cardiac disease | 0.50 | 0.28–0.90 | 0.021 | Dilated cardiomyopathy | 1.76 | 1.15–2.67 | 0.009 | |||
| Prior TIA | 1.78 | 1.01–3.13 | 0.047 | Thyroid disease | 1.57 | 1.10–2.25 | 0.013 | |||
| COPD | 1.56 | 1.13–2.16 | 0.007 | 1.55 | 1.09–2.19 | 0.014 | Known history of AF | 1.50 | 1.16–1.93 | 0.002 |
| Body mass index | 0.96 | 0.93–0.99 | 0.003 | 0.97 | 0.94–0.99 | 0.033 | Paroxysmal AF | 0.32 | 0.24–0.42 | <0.001 |
| Known history of AF | 0.57 | 0.43–0.74 | <0.001 | 0.68 | 0.51–0.91 | 0.010 | Body mass index | 1.06 | 1.03–1.08 | <0.001 |
| Paroxysmal AF | 1.91 | 1.50–2.48 | <0.001 | 2.42 | 1.84–3.20 | <0.001 | Centre in the capital city | 1.98 | 1.58–2.49 | <0.001 |
| Centre in the capital city | 0.45 | 0.34–0.59 | <0.001 | 0.40 | 0.30–0.54 | <0.001 | Treatment by a cardiologist | 1.37 | 1.06–1.78 | 0.016 |
| Treatment by a cardiologist | 0.68 | 0.51–0.90 | 0.007 | 0.67 | 0.50–0.91 | 0.010 | ||||
OAC: oral anticoagulant; OR: Odds Ratio; CI: Confidence Interval; DAPT: dual antiplatelet drug therapy; AF: atrial fibrillation; MI: Myocardial infarction; PCI: percutaneous coronary intervention; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; TIA: transient ischemic attack.