Discontinuation of direct oral anticoagulants among patients with atrial fibrillation according to gender and cohabitation status: a nationwide cohort study
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Discontinuation of direct oral anticoagulants among patients with atrial fibrillation according to gender and cohabitation status : a nationwide cohort study. / Binding, Casper; Olesen, Jonas Bjerring; Lee, Christina Ji-Young; Lip, Gregory Y H; Sindet-Petersen, Caroline; Gislason, Gunnar; Bonde, Anders Nissen.
I: European Heart Journal - Cardiovascular Pharmacotherapy, Bind 8, Nr. 4, 2022, s. 353–362.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Discontinuation of direct oral anticoagulants among patients with atrial fibrillation according to gender and cohabitation status
T2 - a nationwide cohort study
AU - Binding, Casper
AU - Olesen, Jonas Bjerring
AU - Lee, Christina Ji-Young
AU - Lip, Gregory Y H
AU - Sindet-Petersen, Caroline
AU - Gislason, Gunnar
AU - Bonde, Anders Nissen
PY - 2022
Y1 - 2022
N2 - Aims The aim of this study was to evaluate the risk of discontinuing treatment with direct oral anticoagulants (DOACs) among patients with atrial fibrillation (AF) according to cohabitation status and gender. Methods and results Using the Danish national registers, we identified 32 364 patients with AF aged 40-90 years undergoing treatment with DOACs. The study period was from 2013 to 2017, and patients were followed for 2 years, or until death, outcome, or emigration. The main outcome was discontinuation of DOAC treatment for at least 30 days. The absolute 2-year risk of DOAC discontinuation was highest among men living alone [35.7%, 95% confidence interval (CI): 37.3-34.1%]. Men living alone had a 4.6% (95% CI: 6.4-2.8%) higher absolute risk of discontinuation and a 12% [hazard ratio (HR): 1.12, 95% CI: 1.04-1.20] higher relative risk of discontinuation compared with men living with a partner. Female patients living alone likewise had a higher absolute risk of DOAC discontinuation (2.6%, 95% CI: 4.4-0.09%) compared with female patients living with a partner, yet no statistically significant difference in relative risk. In an analysis evaluating gender, we found male gender to be associated with a significantly higher relative risk of DOAC discontinuation (HR: 1.33, 95% CI: 1.26-1.40) compared with female gender (P-value for interaction with cohabitant status = 0.5996). Conclusion In this nationwide population study, male gender and living alone were associated with a higher risk of DOAC discontinuation among patients with AF.
AB - Aims The aim of this study was to evaluate the risk of discontinuing treatment with direct oral anticoagulants (DOACs) among patients with atrial fibrillation (AF) according to cohabitation status and gender. Methods and results Using the Danish national registers, we identified 32 364 patients with AF aged 40-90 years undergoing treatment with DOACs. The study period was from 2013 to 2017, and patients were followed for 2 years, or until death, outcome, or emigration. The main outcome was discontinuation of DOAC treatment for at least 30 days. The absolute 2-year risk of DOAC discontinuation was highest among men living alone [35.7%, 95% confidence interval (CI): 37.3-34.1%]. Men living alone had a 4.6% (95% CI: 6.4-2.8%) higher absolute risk of discontinuation and a 12% [hazard ratio (HR): 1.12, 95% CI: 1.04-1.20] higher relative risk of discontinuation compared with men living with a partner. Female patients living alone likewise had a higher absolute risk of DOAC discontinuation (2.6%, 95% CI: 4.4-0.09%) compared with female patients living with a partner, yet no statistically significant difference in relative risk. In an analysis evaluating gender, we found male gender to be associated with a significantly higher relative risk of DOAC discontinuation (HR: 1.33, 95% CI: 1.26-1.40) compared with female gender (P-value for interaction with cohabitant status = 0.5996). Conclusion In this nationwide population study, male gender and living alone were associated with a higher risk of DOAC discontinuation among patients with AF.
KW - Atrial fibrillation
KW - DOAC
KW - Anticoagulation
KW - Compliance
KW - Discontinuation
KW - WARFARIN
KW - RISK
KW - ADHERENCE
KW - OUTCOMES
U2 - 10.1093/ehjcvp/pvab065
DO - 10.1093/ehjcvp/pvab065
M3 - Journal article
C2 - 34415024
VL - 8
SP - 353
EP - 362
JO - European Heart Journal - Cardiovascular Pharmacotherapy
JF - European Heart Journal - Cardiovascular Pharmacotherapy
SN - 2055-6837
IS - 4
ER -
ID: 302824919