Antithrombotic use and bleeding risk in patients with atrial fibrillation: findings from a multipayer analysis

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). Included patients were aged ≥18 years with a new or existing diagnosis of AF. Outcomes were assessed over 1 year and included stroke risk (CHADS /CHA DS -VASc score), bleeding risk (ATRIA score) and anticoagulant use. : A total of 115,906 patients with AF met inclusion criteria between six databases. Among patients with high stroke risk (CHADS ≥2) and low bleeding risk (ATRIA 0-3), 42-82% did not receive an antithrombotic. Levels of thromboprophylaxis for high-risk AF patients in real-world data differ significantly from current medical guidelines for stroke prevention.