Significant gender gaps exist in use of oral anticoagulants (OAC) to treat patients with non-valvular atrial fibrillation (AFib), according to new research from the ACC's PINNACLE Registry presented as part of AHA 2015 in Orlando. Specifically, women with an indication for anticoagulation are less likely than men to have OAC prescribed across all strata of risk.

The study looked at approximately 700,000 patients diagnosed with non-valvular AFib and indication for OAC (CHADS2VASc >/= 2) between May 1, 2008 and Dec. 31, 2014. Patients were distributed across all high thromboembolic risk strata, with 47.8 percent of them identified as female. The primary outcome was prescription of an OAC agent, including warfarin or a novel OAC (NOAC) like dabigatran, rivaroxaban or apixaban.

Overall, the data showed fewer than one in three patients with an indication for OAC received it, with women 9-30 percent less likely to have an OAC prescribed compared to men of similar thromboembolic risk. The researchers did note a rapid increase in the use of NOACs in both men (53.5 percent each year) and women (57 percent each year) for non-valvular AFib since U.S. Food and Drug Administration approval of dabigatran in 2010. In the last quarter of 2014, NOAC vs. warfarin use was 33.9 percent vs. 24.0 percent, respectively, (p< 0.001) in women and 33.7 percent vs. 27.7 percent, respectively, in men.

"While overall OAC use has slightly increased since 2010, one-third of patients still remain without OAC in the first year after AFib diagnosis in the U.S.," said lead author Lauren E Thompson, MD, FACC. "And women remain significantly less likely to receive OAC compared to men." Thompson noted that further research is needed moving forward to understand why these differences exist.

Keywords: Anticoagulants, Atrial Fibrillation, Benzimidazoles, Cytarabine, Morpholines, Pyrazoles, Pyridones, Registries, United States Food and Drug Administration, Warfarin, National Cardiovascular Data Registries, PINNACLE Registry

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