Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Disparities in Use of Oral Anticoagulants for AF

JAMA Cardiol; ePub 2018 Nov 28; Essien, et al

In a large cohort study of outpatients with atrial fibrillation (AF), black patients were significantly less likely than white individuals to receive direct-acting oral anticoagulants (DOACs) for atrial fibrillation (AF). Researchers assessed the racial/ethnic differences in the use of oral anticoagulants, particularly DOACs, in patients with AF. The primary outcome was use of any oral anticoagulant, particularly DOACs. Secondary outcomes included the quality of anticoagulation received and oral anticoagulant discontinuation at 1 year. Among the details:

  • The study included 12,417 patients (11,100 white individuals (88.6%), 646 black individuals (5.2%), and 671 Hispanic individuals (5.4%) with AF.
  • After controlling for clinical and socioeconomic factors, black patients were less likely than white patients to receive DOACs for AF, with no difference between white and Hispanic groups.
  • The quality of anticoagulant use was lower in black and Hispanic individuals when AF was treated.


Essien UR, Holmes DN, Jackson LR, et al. Association of race/ethnicity with oral anticoagulant use in patients with atrial fibrillation. Findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II. [Published online ahead of print November 28, 2018]. JAMA Cardiol. doi:10.1001/jamacardio.2018.3945.

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