Table 3.
Anticoagulation Fill Patterns of Patients with Nonvalvular Atrial Fibrillation, 2009–2014
| 2009–2014 | Total | Cardiology | Primary Care | RR*† (95%CI) | RR*‡ (95%CI) |
|---|---|---|---|---|---|
| All (N=223,891) | 69% | 31% | |||
| Anticoagulant | 31% | 35% | 19% | 1.67 (1.64, 1.69) | 1.66 (1.63, 1.69) |
| DOAC | 11% | 13% | 4% | 2.59 (2.49, 2.68) | 2.57 (2.48, 2.68) |
| Warfarin | 20% | 22% | 15% | 1.38 (1.35, 1.41) | 1.38 (1.35, 1.41) |
| CHA2DS2-VASc ≥ 2 (N=191,898) | 67% | 33% | |||
| Anticoagulant | 31% | 36% | 20% | 1.65 (1.63, 1.68) | 1.65 (1.62, 1.68) |
| DOAC | 11% | 13% | 5% | 2.55 (2.45, 2.65) | 2.53 (2.43, 2.64) |
| Warfarin | 20% | 23% | 15% | 1.38 (1.35, 1.41) | 1.39 (1.35, 1.42) |
Comparison between cardiology and primary care.
Relative risk of anticoagulant, DOAC, and warfarin prescription fills for patients seen by cardiology vs. primary care providers. Adjusted for age, sex, race, education, heart failure, hypertension, diabetes, stroke, myocardial infarction, kidney disease, liver disease, bleeding history, alcohol use, antiplatelet agents, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, antiarrhythmic agents, digoxin, CHA2DS2-VASc, and HAS-BLED.
Results of 1:1 propensity score matched analysis. Propensity score was computed using multivariable logistic regression with the following variables: age, sex, race, education, heart failure, hypertension, diabetes, stroke, myocardial infarction, kidney disease, liver disease, bleeding history, alcohol use, antiplatelet agents, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, diuretics, antiarrhythmic agents, digoxin, CHA2DS2-VASc, and HAS-BLED. Adjusted for all covariates used to derive the propensity-matched cohort (N=138,170).
CHA2DS2-VASc=congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65–75 years, and sex category; CI=confidence interval; DOAC=direct oral anticoagulant; HAS-BLED=hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly (age >65 years), drugs/alcohol concomitantly; RR=relative risk.