Temporal trends in the use of anticoagulants among older adults with atrial fibrillation

Nicholas L. Smith, Bruce M. Psaty, Curt D. Furberg, Richard H White, Joao A C Lima, Anne B. Newman, Teri A. Manolio

Research output: Contribution to journalArticle

106 Scopus citations

Abstract

Background: Several recent randomized clinical trials have demonstrated that warfarin sodium treatment, and to a lesser extent aspirin, reduces risk of stroke and death compared with placebo in persons with atrial fibrillation. Insufficient documentation exists on the extent to which the use of these therapies following trial publications has continued to increase in the elderly with atrial fibrillation. Methods: We used data from the Cardiovascular Health Study, a study of 5888 community-dwelling adults aged 65 years or older, to determine the prevalence of warfarin and aspirin use in persons with electrocardiogram-identified atrial fibrillation. Electrocardiogram examinations were conducted at baseline from 1989 through 1990, and at 6 subsequent annual examinations through 1995-1996. Medication data were collected by inventory methods at each examination. Temporal change in use of anticoagulants was analyzed by comparing percentage use in 1990 to use in each year through 1996. Results: The use of warfarin increased 4-fold from 13% in 1990 to 50% in 1996 among participants with prevalent atrial fibrillation (P<.001). Daily use of aspirin did not increase over time. Participants younger than 80 years were 4 times more likely to use warfarin in 1996 (P<.001) than those 80 years and older. Use of aspirin did not vary significantly with age. Conclusions: Warfarin use in community-dwelling elderly persons with electrocardiogram-documented atrial fibrillation increased steadily following the first publication of its treatment benefit, reaching 50% by 1996. In contrast, use of aspirin was unchanged during this same period. Continued efforts to promote appropriate anticoagulation therapy to physicians and their patients may still be needed.

Original languageEnglish (US)
Pages (from-to)1574-1578
Number of pages5
JournalArchives of Internal Medicine
Volume159
Issue number14
DOIs
StatePublished - Jul 26 1999

ASJC Scopus subject areas

  • Internal Medicine

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    Smith, N. L., Psaty, B. M., Furberg, C. D., White, R. H., Lima, J. A. C., Newman, A. B., & Manolio, T. A. (1999). Temporal trends in the use of anticoagulants among older adults with atrial fibrillation. Archives of Internal Medicine, 159(14), 1574-1578. https://doi.org/10.1001/archinte.159.14.1574