Anticoagulation for New-Onset A-Fib in Hospitalized Patients

Clinical Takeaway

: DOAC initiation was associated with lower 3-year risk of myocardial infarction, stroke, or death in an observational study.

Context

In patients with atrial fibrillation (AF) that develops during hospitalization, clinicians must decide whether to initiate long-term anticoagulation. To help inform this decision, researchers retrospectively examined outcomes in 16,600 adults with new-onset AF occurring within 3 days before or during hospitalization and no prior direct oral anticoagulant (DOAC) use. Of these, 43% were discharged on DOAC therapy.

Key Results

At baseline, DOAC recipients were substantially more likely than nonrecipients to have a history of heart failure, but less likely to have histories of chronic kidney disease, myocardial infarction (MI), and major bleeding events. Mean CHA₂DS₂-VASc scores were ≈4 in both groups.
At 3 years, in unadjusted analyses, DO…

Reviewing Author

Kathleen Finn, M.D., M.Phil., S.F.H.M.

Disclosures

Leadership Roles in Professional SocietiesAlliance for Academic Internal Medicine (Treasurer, Association of Program Directors in Internal Medicine Council)