Anticoagulation discharge treatment recommendations in patients admitted with a first-time diagnosis of atrial fibrillation

This study demonstrates a significant shift towards DOACs as the preferred anticoagulation therapy for newly diagnosed AF patients, aligning with current guidelines. However, CKD remains a factor influencing DOAC prescription. Key messages What is already known on this topic: Atrial fibrillation (AF) increases stroke risk, traditionally managed with warfarin but now increasingly treated with direct oral anticoagulants (DOACs). However, research is limited on anticoagulation recommendations at discharge in newly diagnosed AF patients, highlighting the need to understand clinical factors influencing these decisions. What this study adds: This study reveals a complete shift to DOAC prescription for newly diagnosed AF patients, with apixaban preferred in older patients. Although studies in recent years suggest that DOACs can be safe and effective in patients with chronic kidney disease (CKD), we find that DOACs prescriptions were less prevalent in these patients in comparison with warfarin. How this study might affect research, practice or policy: These findings suggest an opportunity to enhance clinician awareness and guidelines around DOAC use in elderly or CKD patients, potentially guiding future research and policy to improve AF management in these subgroups.