Table 2.
Risk of being non-persistent with oral anticoagulant according to baseline characteristics of the study population
| Variables | Observation time (PY) | No. events | Hazard ratio | Hazard ratio | Hazard ratio | Hazard ratio |
|---|---|---|---|---|---|---|
| (95% CI) | (95% CI)c | (95% CI)c,d | (95% CI)c,d,e | |||
| Sex | ||||||
| Female | 67 804 | 5965 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Male | 88 266 | 9656 | 1.25 (1.21–1.29) | 1.10 (1.07–1.14) | 1.13 (1.08–1.17) | 1.06 (1.01–1.12) |
| Age (years) | 156 069 | 15 621 | 0.97 (0.97–0.97) | 0.97 (0.97–0.97) | 0.96 (0.96–0.97) | 1.02 (1.02–1.02) |
| Age group (years) | ||||||
| 18–34 | 266 | 234 | 11.14 (9.76–12.71) | 10.82 (9.48–12.35) | 12.96 (11.19–15) | 3.70 (1.39–9.86) |
| 35–44 | 1307 | 587 | 6.43 (5.89–7.01) | 6.29 (5.76–6.86) | 7.87 (7.11–8.71) | 2.96 (1.94–4.51) |
| 45–54 | 8650 | 2044 | 3.60 (3.41–3.80) | 3.54 (3.35–3.73) | 4.26 (3.98–4.55) | 1.55 (1.29–1.86) |
| 55–64 | 29 088 | 3535 | 1.89 (1.81–1.98) | 1.87 (1.79–1.96) | 2.23 (2.10–2.36) | 1.30 (1.17–1.44) |
| 65–74 | 61 673 | 3967 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 75–84 | 42 597 | 3464 | 1.20 (1.14–1.25) | 1.22 (1.16–1.27) | 1.12 (1.06–1.19) | 1.19 (1.11–1.27) |
| ≥85 | 12 488 | 1790 | 1.90 (1.79–2.01) | 1.97 (1.86–2.08) | 1.92 (1.79–2.05) | 2.01 (1.87–2.16) |
| Subtype of AFa | ||||||
| Permanent | 6080 | 692 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Paroxysmal | 18 411 | 2378 | 1.15 (1.06–1.25) | 1.17 (1.07–1.27) | 1.24 (1.12–1.37) | 1.19 (1.03–1.36) |
| Previous exposure to VKA | ||||||
| Yes | 54 273 | 3897 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 101 796 | 11 724 | 1.50 (1.45–1.56) | 1.55 (1.50–1.61) | 1.85 (1.76–1.95) | 1.60 (1.50–1.71) |
| Stroke history (including TIA) | ||||||
| Yes | 15 445 | 1163 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 140 624 | 14 458 | 1.40 (1.32–1.49) | 1.26 (1.18–1.33) | 1.44 (1.33–1.56) | 1.21 (1.12–1.32) |
| Immigration status | ||||||
| Native | 136 916 | 13 425 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| First generation | 9928 | 1223 | 1.24 (1.17–1.32) | 1.19 (1.12–1.26) | 1.09 (1.01–1.17) | 1.29 (1.17–1.42) |
| Second generation | 9225 | 973 | 1.08 (1.01–1.15) | 1.08 (1.02–1.16) | 1.04 (0.96–1.13) | 1.07 (0.95–1.19) |
| Marital status | ||||||
| Married or in partnership | 100 400 | 9185 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Unmarried or single | 10 269 | 1673 | 1.72 (1.63–1.81) | 1.38 (1.30–1.45) | 1.34 (1.26–1.43) | 1.51 (1.36–1.69) |
| Divorced | 16 870 | 2033 | 1.29 (1.23–1.35) | 1.24 (1.18–1.30) | 1.16 (1.09–1.23) | 1.29 (1.19–1.41) |
| Widowed | 28 530 | 2730 | 0.99 (0.95–1.03) | 1.41 (1.35–1.48) | 1.40 (1.32–1.48) | 1.14 (1.06–1.22) |
| Standardized household incomeb | ||||||
| First quintile (0–20%) | 18 440 | 2095 | 1.31 (1.24–1.38) | 1.44 (1.36–1.52) | 1.39 (1.30–1.49) | 1.27 (1.17–1.38) |
| Second quintile (20–40%) | 39 390 | 3408 | 1.04 (0.99–1.09) | 1.14 (1.09–1.20) | 1.07 (1.01–1.14) | 1.04 (0.96–1.12) |
| Third quintile (40–60%) | 39 866 | 3245 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Fourth quintile (60–80%) | 30 599 | 3011 | 1.23 (1.17–1.29) | 1.11 (1.05–1.17) | 1.09 (1.03–1.16) | 0.98 (0.90–1.08) |
| Fifth quintile (80–100%) | 26 078 | 3529 | 1.70 (1.62–1.78) | 1.37 (1.30–1.44) | 1.39 (1.30–1.47) | 1.15 (1.04–1.28) |
| CHA2DS2-VASc score | ||||||
| Clinical categories | ||||||
| ≥2 (high risk) | 113 078 | 9075 | 1 (reference) | – | – | – |
| 1 (moderate risk) | 30 232 | 3240 | 1.43 (1.37–1.48) | – | – | – |
| 0 (low risk) | 12 760 | 3306 | 3.35 (3.21–3.48) | – | – | – |
| Any category | ||||||
| 7–9 | 2013 | 232 | 1.34 (1.17–1.53) | – | – | – |
| 6 | 5086 | 491 | 1.14 (1.04–1.26) | – | – | – |
| 5 | 11 536 | 1057 | 1.11 (1.04–1.20) | – | – | – |
| 4 | 21 476 | 1758 | 1.02 (0.96–1.08) | – | – | – |
| 3 | 34 092 | 2638 | 1.00 (0.95–1.05) | – | – | – |
| 2 | 38 874 | 2899 | 1 (reference) | – | – | – |
| 1 | 30 232 | 3240 | 1.47 (1.40–1.54) | – | – | – |
| 0 | 12 760 | 3306 | 3.44 (3.27–3.62) | – | – | – |
AF, atrial fibrillation; CI, confidence interval; OAC, oral anticoagulant; PY, person-year; TIA, transient ischaemic attack; VKA, vitamin K antagonist.
Subtypes of AF were only available for AF diagnosed after 2015. The subtype of unspecified AF was not included into the analysis. The subtypes of persistent AF, chronic AF, type I atrial flutter, and type II atrial flutter were categorized as “Permanent”.
Private household with an unknown income and institutional household were not included into the analysis. Percentile groups were determined based on disposable income of private households of the whole target population in the database (instead of the study population only).
Adjusted for age and sex.
Restrict the follow-up to up to 1 year after the first DOAC prescription.
Restrict to patients who had a baseline CHA2DS2-VASc score ≥2.