| Title: |
Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation |
| Authors: |
Fenger-Grøn, Morten; Vestergaard, Claus Høstrup; Ribe, Anette Riisgaard; Johnsen, Søren Paaske; Frost, Lars; Sandbæk, Annelli; Davydow, Dimitry S |
| Source: |
Fenger-Grøn, M, Vestergaard, C H, Ribe, A R, Johnsen, S P, Frost, L, Sandbæk, A & Davydow, D S 2021, 'Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation', JAMA network open, vol. 4, no. 5, e2110096. https://doi.org/10.1001/jamanetworkopen.2021.10096 |
| Publication Year: |
2021 |
| Collection: |
Aarhus University: Research |
| Description: |
Importance: Individuals with bipolar disorder or schizophrenia have a higher risk of adverse outcomes from cardiovascular diseases. Oral anticoagulation therapy (OAT) for patients with atrial fibrillation (AF) is needed for stroke prevention, but whether patients with bipolar disorder or schizophrenia face disparities in receiving this therapy is unknown. Objective: To assess whether bipolar disorder or schizophrenia is associated with a lower rate of OAT initiation in patients with incident AF and lower prevalence of OAT in those with prevalent AF. Design, Setting, and Participants: A nationwide cohort study of Danish patients with AF was conducted from January 1, 2005, to December 31, 2016, and data were analyzed from January 1 to June 15, 2020. Data from national registries included information on all redeemed prescriptions and all hospital contacts of all patients with incident or prevalent AF (age, 18-100 years) and increased risk status, defined by a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) risk score greater than or equal to 2. Exposures: Hospital diagnosis of bipolar disorder or schizophrenia. Main Outcomes and Measures: Adjusted proportion differences for OAT initiation and OAT prevalence, comparing individuals with and without bipolar disorder or schizophrenia. Results: Patients included with incident AF (n = 147 810) had a mean (SD) age of 76.9 (10.1) years, 78 577 (53.2%) were women, 1208 (0.8%) had bipolar disorder, and 572 (0.4%) had schizophrenia. Accounting for age, sex, and calendar time, bipolar disorder and schizophrenia were associated with significantly lower frequency of OAT initiation within 90 days after incident AF (bipolar disorder: -12.7%; 95% CI, -15.3% to -10.0%; schizophrenia: -24.5%; 95% CI, -28.3% to -20.7%) and lower OAT prevalence in patients with prevalent AF (bipolar disorder: -11.6%; 95% CI, -13.9% to -9.3% schizophrenia: -21.6%; 95% CI, -24.8% to ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
2574-3805 |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/33999163; info:eu-repo/semantics/altIdentifier/pissn/2574-3805; info:eu-repo/semantics/altIdentifier/eissn/2574-3805 |
| DOI: |
10.1001/jamanetworkopen.2021.10096 |
| Availability: |
https://pure.au.dk/portal/en/publications/b27f9c40-ba1f-4d61-85ac-cce8ff104535; https://doi.org/10.1001/jamanetworkopen.2021.10096; https://www.scopus.com/pages/publications/85106169464 |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.7B633EAD |
| Database: |
BASE |