Rural-urban differences in the initiation of oral anticoagulant therapy in patients with incident atrial fibrillation : A Finnish nationwide cohort study

dc.contributorAalto-yliopistofi
dc.contributorAalto Universityen
dc.contributor.authorTeppo, Konsta
dc.contributor.authorJaakkola, Jussi
dc.contributor.authorLangén, Ville L.
dc.contributor.authorBiancari, Fausto
dc.contributor.authorHalminen, Olli
dc.contributor.authorLinna, Miika
dc.contributor.authorHaukka, Jari
dc.contributor.authorPutaala, Jukka
dc.contributor.authorMustonen, Pirjo
dc.contributor.authorKinnunen, Janne
dc.contributor.authorLuojus, Alex
dc.contributor.authorHartikainen, Juha
dc.contributor.authorAiraksinen, K. E.Juhani
dc.contributor.authorLehto, Mika
dc.contributor.departmentUniversity of Turku
dc.contributor.departmentTurku University Hospital
dc.contributor.departmentUniversity of Helsinki
dc.contributor.departmentDepartment of Industrial Engineering and Management
dc.contributor.departmentUniversity of Eastern Finland
dc.date.accessioned2022-11-23T08:02:53Z
dc.date.available2022-11-23T08:02:53Z
dc.date.issued2022
dc.description.abstractAIMS: Little is known about rural-urban differences in the treatment and outcomes in patients with atrial fibrillation (AF). We aimed to assess whether the initiation of oral anticoagulant (OAC) therapy in patients with AF differs between those with rural and urban residence. METHODS: The registry-based FinACAF cohort covers all patients with AF from all levels of care in Finland. Patients were divided into rural and urban categories and into urbanization degree tertiles based on their municipality of residence at the time of AF diagnosis. The outcome was the first redeemed OAC prescription. RESULTS: We identified 222 419 patients (50.1% female; mean age 72.8 (SD 13.2) years) with incident AF during 2007-2018. Urban residence was associated with a lower rate of OAC therapy initiation (adjusted subdistribution hazard ratio (SHR) (95% CI) 0.96 (0.95-0.97)). Correspondingly, an inverse graded dose-response relationship was observed between higher urbanization degree tertile and OAC initiation rate (highest tertile compared to lowest: adjusted SHR (95% CI) 0.94 (0.93-0.95)). The adoption of direct oral anticoagulants for stroke prevention was faster among patients with urban residence. CONCLUSION: This nationwide cohort study documented that urban residence is associated with a slightly lower rate of OAC therapy initiation in patients with incident AF, but faster adoption of direct oral anticoagulant use.en
dc.description.versionPeer revieweden
dc.format.extente0276612
dc.format.mimetypeapplication/pdf
dc.identifier.citationTeppo , K , Jaakkola , J , Langén , V L , Biancari , F , Halminen , O , Linna , M , Haukka , J , Putaala , J , Mustonen , P , Kinnunen , J , Luojus , A , Hartikainen , J , Airaksinen , K E J & Lehto , M 2022 , ' Rural-urban differences in the initiation of oral anticoagulant therapy in patients with incident atrial fibrillation : A Finnish nationwide cohort study ' , PloS one , vol. 17 , no. 10 , e0276612 , pp. e0276612 . https://doi.org/10.1371/journal.pone.0276612en
dc.identifier.doi10.1371/journal.pone.0276612
dc.identifier.issn1932-6203
dc.identifier.otherPURE UUID: c1564bb7-d0e3-4ceb-b22c-fa20db4036c7
dc.identifier.otherPURE ITEMURL: https://research.aalto.fi/en/publications/c1564bb7-d0e3-4ceb-b22c-fa20db4036c7
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dc.identifier.otherPURE FILEURL: https://research.aalto.fi/files/92351588/Rural_urban_differences_in_the_initiation_of_oral_anticoagulant_therapy_in_patients_with_incident_atrial_fibrillation.pdf
dc.identifier.urihttps://aaltodoc.aalto.fi/handle/123456789/117865
dc.identifier.urnURN:NBN:fi:aalto-202211236625
dc.language.isoenen
dc.publisherPublic Library of Science
dc.relation.ispartofseriesPloS oneen
dc.relation.ispartofseriesVolume 17, issue 10en
dc.rightsopenAccessen
dc.titleRural-urban differences in the initiation of oral anticoagulant therapy in patients with incident atrial fibrillation : A Finnish nationwide cohort studyen
dc.typeA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessäfi
dc.type.versionpublishedVersion
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