Oral anti-coagulant treatment patterns in atrial fibrillation patients diagnosed with cancer: A Danish nationwide cohort study.

Ording, Anne Gulbech ORCID: 0000-0002-8073-7664, Søgaard, Mette ORCID: 0000-0002-2830-4968, Nielsen, Peter Brønnum ORCID: 0000-0003-2922-6970, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Larsen, Torben Bjerregaard, Grove, Erik Lerkevang and Skjøth, Flemming (2022) Oral anti-coagulant treatment patterns in atrial fibrillation patients diagnosed with cancer: A Danish nationwide cohort study. British journal of haematology, 197 (2). pp. 223-231.

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Official URL: http://dx.doi.org/10.1111/bjh.18060

Abstract

Data on the use of oral anti-coagulants (OAC) for stroke prevention in cancer patients with atrial fibrillation (AF) are sparse. Nationwide cohort study of patients with AF (2012-2018) and an indication for OAC who were diagnosed with cancer at least one year later (N = 12 756). We identified treatment with OAC at cancer diagnosis and the following year and described the incidence of discontinuing or switching between warfarin and direct oral anti-coagulants (DOACs). We also described baseline characteristics associated with OAC non-persistence. One third of the cancer patients received no OAC therapy, whereas 42% received warfarin and 24% received DOAC treatment. Switching incidence between OACs was higher for those receiving warfarin treatment (8.6%) than DOAC treatment (1.7%) within one year. Treatment discontinuation was 61% for warfarin and 26% for DOAC. Females were less likely to discontinue DOAC than males (ratio 0.77, 95% confidence interval: 0.66, 0.90). Increasing cancer stage was associated with discontinuation of DOAC, but not warfarin. OAC for stroke prevention in AF was used by two thirds of patients with newly diagnosed cancer. Switching between OACs and discontinuation was more common for warfarin than DOAC, and females had higher persistence with DOACs.

Item Type:	Article
Uncontrolled Keywords:	Humans, Neoplasms, Atrial Fibrillation, Warfarin, Anticoagulants, Administration, Oral, Cohort Studies, Denmark, Female, Male, Stroke
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	17 Oct 2023 13:58
Last Modified:	17 Oct 2023 13:58
DOI:	10.1111/bjh.18060
Open Access URL:	https://doi.org/10.1111/bjh.18060
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3173822