Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Substantial differences in initiation of oral anticoagulant therapy and clinical outcome among non-valvular atrial fibrillation patients treated in inpatient and outpatient settings

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. C-reactive protein after coronary artery bypass graft surgery and its relationship with postoperative atrial fibrillation

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Defibrillators for prevention from sudden cardiac death: is it that easy?-Authors' reply

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Secondary stroke prophylaxis in atrial fibrillation patients with chronic kidney disease: a nationwide cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Risk Factors for Morbidity and Mortality Following Hospitalization for Pericarditis

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: Patients with atrial fibrillation (AF) are encountered and treated in different healthcare settings, which may affect the quality of care. We investigated the use of oral anticoagulant (OAC) therapy and the risk of thrombo-embolism (TE) and bleeding, according to the healthcare setting.

METHODS AND RESULTS: Using national Danish registers, we categorized non-valvular AF patients (2002-11) according to the setting of their first-time AF contact: hospitalization (inpatients), ambulatory (outpatients), or emergency department (ED). Event rates and hazard ratios (HRs), calculated using Cox regression analysis, were estimated for outcomes of TE and bleeding. We included 116 051 non-valvular AF patients [mean age 71.9 years (standard deviation 14.1), 51.3% males], of whom 55.2% were inpatients, 41.9% outpatients, and 2.9% ED patients. OAC therapy 180 days after AF diagnosis among patients with a CHADS2 ≥ 2 was 42.1, 63.0, and 32.4%, respectively. Initiation of OAC therapy was only modestly influenced by CHADS2 and HAS-BLED scores, regardless of the healthcare setting. The rate of TE was 4.30 [95% confidence interval (CI) 4.21-4.40] per 100 person-years for inpatients, 2.28 (95% CI 2.22-2.36) for outpatients, and 2.30 (95% CI 2.05-2.59) for ED patients. The adjusted HR of TE, with inpatients as reference, was 0.74 (95% CI 0.71-0.77) for outpatients and 0.89 (95% CI 0.79-1.01) for ED patients.

CONCLUSION: In a nationwide cohort of non-valvular AF patients, outpatients were much more likely to receive OAC therapy and had a significantly lower risk of stroke/TE compared with inpatients and ED patients. However, across all settings investigated, OAC therapy was far from optimal.

Original languageEnglish
JournalEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Volume18
Issue number4
Pages (from-to)492-500
Number of pages9
ISSN1099-5129
DOIs
Publication statusPublished - Apr 2016

ID: 46469931