Anticoagulation Drug Prescription Disparities Impact Mortality and Stroke Rates

Purpose: Medication prescription patterns vary significantly according to geographic location and race. We aimed to assess the impact of race on anticoagulation (AC) prescription patterns among patients in New Orleans with atrial fibrillation (AF) and the impact of AC type on death and stroke.

Material and Methods: Our study included 1196 patients from the regional US electronic medical records database (Research Action for Health Network database) diagnosed with AF between January 2010 and December 2019. We calculated differences in AC prescription patterns across different races, and the implications of AC type on stroke and death among African American individuals using “time-to-event” Kaplan-Meier representations.

Results: A total of 1196 patients taking anticoagulation were included, of whom 44% were on warfarin and 56% on direct oral anticoagulants (DOACs). African Americans were prescribed warfarin more than DOAC (50.6% vs 43.5%), whereas white patients tend to use DOACs more than warfarin (56.5% vs 49.4%, p=0.01). Among African American patients, rates of stroke (Figure 1a, HR 0.22, 95% CI 0.1-0.49, p< 0.001) and death (Figure 1b, HR 0.35, 95% CI 0.18-0.65, p< 0.001) were significantly lower among those prescribed DOACs.

Conclusions: African American patients were less likely to be prescribed DOACS, and this had significant implications on the rates of mortality and stroke.