Oral Anticoagulant Therapy of Patients With Atrial Fibrillation in Cardiology, Internal Medicine, and Surgery: Temporal Trend

This study aimed to assess the status of oral anticoagulant (OAC) therapy among Chinese patients with atrial fibrillation (AF) across various hospital departments, influenced by recent changes in medical insurance policies. It retrospectively analyzed data from 70,187 AF patients treated between January 2018 and December 2023 across 20 hospitals. The average patient age was 72.3 years, with 54.4% male. The study found a significant increase in OAC use over time, particularly in cardiology, where the usage rose from 29.8% pre-2018 to 68.8% in 2021-2023. However, OAC usage in non-cardiology departments remained below 50% during the same period. Tertiary hospitals had higher OAC prescription rates compared to non-tertiary hospitals. Despite 77.4% of the cohort being at high risk for stroke, their OAC usage rates were not higher than the non-high-risk group. Factors such as advanced age, history of bleeding, hemoglobin levels, and concurrent antiplatelet therapy hindered OAC use, while upstream treatments facilitated its acceptance. The study concludes that while progress has been made in OAC prescription in China, significant gaps remain, especially in internal medicine and surgery departments, necessitating targeted interventions and better interdisciplinary collaboration for improved patient outcomes.