title: Antithrombotic use and bleeding risk in patients with atrial fibrillation: findings from a multipayer analysis.
abstract: OBJECTIVE
  To analyze administrative claims data from Medicaid, Medicare and commercial insurance sources to estimate stroke risk, bleeding risk, and the use of antithrombotic treatment in patients with atrial fibrillation (AF).
  
  
  METHODS
  Included patients were aged ≥18 years with a new or existing diagnosis of AF. Outcomes were assessed over 1 year and included stroke risk (CHADS2/CHA2DS2-VASc score), bleeding risk (ATRIA score) and anticoagulant use.
  
  
  RESULTS
  A total of 115,906 patients with AF met inclusion criteria between six databases. Among patients with high stroke risk (CHADS2 ≥2) and low bleeding risk (ATRIA 0-3), 42-82% did not receive an antithrombotic.
  
  
  CONCLUSIONS
  Levels of thromboprophylaxis for high-risk AF patients in real-world data differ significantly from current medical guidelines for stroke prevention.
authors.affiliation: Boston Health Economics, Inc., 20 Fox Road, Waltham, MA 02451, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lang
authors.affiliation: Boston Health Economics, Inc., 20 Fox Road, Waltham, MA 02451, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Federico
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 Route 202, Raritan, NJ 08869, USA.
authors.forename: Aarti A
authors.initials: AA
authors.lastname: Patel
authors.affiliation: Boston Health Economics, Inc., 20 Fox Road, Waltham, MA 02451, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Munsell
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 Route 202, Raritan, NJ 08869, USA.
authors.forename: Winnie W
authors.initials: WW
authors.lastname: Nelson
authors.affiliation: Gary Owens Associates, Inc. PO Box 810, Ocean View, DE 19970, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Owens
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 Route 202, Raritan, NJ 08869, USA.
authors.forename: Samir H
authors.initials: SH
authors.lastname: Mody
authors.affiliation: Janssen Scientific Affairs, LLC, 1000 Route 202, Raritan, NJ 08869, USA.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Schein
authors.affiliation: Boston Health Economics, Inc., 20 Fox Road, Waltham, MA 02451, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Menzin
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D006278:Medicare; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced; D014481:United States
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; atrial fibrillation; hemorrhage; outcomes research; stroke