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, Konstaen_US
dc.contributor.authorJaakkola, Jussien_US
dc.contributor.authorLangén, Ville L.en_US
dc.contributor.authorBiancari, Faustoen_US
dc.contributor.authorHalminen, Ollien_US
dc.contributor.authorLinna, Miikaen_US
dc.contributor.authorHaukka, Jarien_US
dc.contributor.authorPutaala, Jukkaen_US
dc.contributor.authorMustonen, Pirjoen_US
dc.contributor.authorKinnunen, Janneen_US
dc.contributor.authorLuojus, Alexen_US
dc.contributor.authorHartikainen, Juhaen_US
dc.contributor.authorAiraksinen, K. E.Juhanien_US
dc.contributor.authorLehto, Mikaen_US
dc.contributor.departmentDepartment of Industrial Engineering and Managementen
dc.contributor.organizationUniversity of Turkuen_US
dc.contributor.organizationTurku University Hospitalen_US
dc.contributor.organizationUniversity of Helsinkien_US
dc.contributor.organizationUniversity of Eastern Finlanden_US
dc.date.accessioned2022-11-23T08:02:53Z
dc.date.available2022-11-23T08:02:53Z
dc.date.issued2022en_US
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.mimetypeapplication/pdfen_US
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.0276612en_US
dc.identifier.issn1932-6203
dc.identifier.otherPURE UUID: c1564bb7-d0e3-4ceb-b22c-fa20db4036c7en_US
dc.identifier.otherPURE ITEMURL: https://research.aalto.fi/en/publications/c1564bb7-d0e3-4ceb-b22c-fa20db4036c7en_US
dc.identifier.otherPURE LINK: http://www.scopus.com/inward/record.url?scp=85140939685&partnerID=8YFLogxK
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.pdfen_US
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 10, pp. e0276612en
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

Files