title: Increased use of oral anticoagulants in patients with atrial fibrillation: temporal trends from 2005 to 2015 in Denmark.
abstract: OBJECTIVE
  The aim of this study is to examine temporal trends in the use oral anticoagulants (OAC) as stroke prophylaxis in patients with atrial fibrillation (AF) and to examine factors associated with OAC initiation.
  
  
  RESULTS
  From Danish nationwide registries, we identified patients diagnosed with AF at Danish hospitals and outpatient clinics between January 2005 and June 2015. OAC initiation was assessed from prescription fills ±180 days from date of AF diagnosis. We identified a total of 108 410 patients with newly diagnosed AF. Before 2010, 40-50% initiated OAC treatment. From 2010, OAC initiation rates increased (P < 0.0001 for trend) and by June 2015, 66.5% of the incident AF patients were initiated on OAC (74.5% increase since December 2009). Increased OAC prescription was especially seen among females and 'fragile' patients (age > 75 years and high risk of stroke). The increased OAC initiation was accompanied by introduction and increased uptake of the NOACs. By the end of the study, NOACs accounted for 72.5% of all OACs prescribed in newly diagnosed AF patients. OAC initiation was associated with male gender, age 65-74 years, few comorbidities and increased risk of stroke.
  
  
  CONCLUSIONS
  Since 2010, more incident AF patients in Denmark were initiated on OAC therapy with predominant NOAC prescription. The increase was pronounced among females, among patients at high risk of stroke, and among older patients.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Gadsbøll
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.
authors.forename: Laila
authors.initials: L
authors.lastname: Staerk
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen Ø 2100, Denmark.|The Danish Heart Foundation, Copenhagen K, Copenhagen 1127, Denmark.
authors.forename: Emil Loldrup
authors.initials: EL
authors.lastname: Fosbøl
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.
authors.forename: Caroline
authors.initials: C
authors.lastname: Sindet-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.
authors.forename: Anna
authors.initials: A
authors.lastname: Gundlund
authors.affiliation: University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK.
authors.forename: Gregory Y H
authors.initials: GYH
authors.lastname: Lip
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.|The Danish Heart Foundation, Copenhagen K, Copenhagen 1127, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N 2200, Denmark.|The National Institute of Public Health, University of Southern Denmark, Copenhagen K 1353, Denmark.
authors.forename: Gunnar Hilmar
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup 2900, Denmark.
authors.forename: Jonas Bjerring
authors.initials: JB
authors.lastname: Olesen
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation ; NOAC; OAC ; Oral anticoagulation ; VKA 