@article{0ef339ce14474a77bbcb2985a16a4e1e,
title = "Temporal trends of gender disparities in oral anticoagulant use in patients with atrial fibrillation",
abstract = "Aims: To investigate sex-specific temporal trends in the initiation of oral anticoagulant (OAC) therapy among patients diagnosed with atrial fibrillation (AF) in Finland between 2007 and 2018. Methods: The registry-linkage Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) Study included all patients with incident AF in Finland from 2007 to 2018. The primary outcome was the initiation of any OAC therapy. Results: We identified 229,565 patients with new-onset AF (50.0% women; mean age 72.7 years). The initiation of OAC therapy increased continuously during the observation period. While women were more likely to receive OAC therapy overall, after adjusting for age, stroke risk factors and other confounding factors, female sex was associated with a marginally lower initiation of OACs (unadjusted and adjusted hazard ratios comparing women to men: 1.08 (1.07–1.10) and 0.97 (0.96–0.98), respectively). Importantly, the gender disparities in OAC use attenuated and reached parity by the end of the observation period. Furthermore, when only patients eligible for OAC therapy according to the contemporary guidelines were included in the analyses, the gender inequalities in OAC initiation appeared minimal. Implementation of direct OACs for stroke prevention was slightly slower among women. Conclusion: This nationwide retrospective cohort study covering all patients with incident AF in Finland from 2007 to 2018 observed that although female sex was initially associated with a lower initiation of OAC therapy, the sex-related disparities resolved over the course of the study period.",
keywords = "atrial fibrillation, gender disparities, oral anticoagulant therapy, stroke prevention, temporal trends",
author = "Konsta Teppo and Airaksinen, {K. E.Juhani} and Jussi Jaakkola and Olli Halminen and Birgitta Salmela and Ksenia Kalatsova and Elis Kouki and Jari Haukka and Jukka Putaala and Miika Linna and Aro, {Aapo L.} and Pirjo Mustonen and Juha Hartikainen and Mika Lehto",
note = "Funding Information: This work was supported by the Aarne Koskelo Foundation, The Finnish Foundation for Cardiovascular Research, and Helsinki and Uusimaa Hospital District research fund (TYH2019309). Funding Information: Konsta Teppo: Research Grants: The Finnish Foundation for Cardiovascular Research, Aarne and Aili Turunen Foundation. Jussi Jaakkola: none. Olli Halminen: none. Janne Kinnunen: none. Jukka Putaala: Speaker: Bayer, Boehringer‐Ingelheim, BMS‐Pfizer, Abbott; Advisory board: Portola, Novo Nordisk, Herantis Pharma; Visiting editor: Terve Media; Stock ownership: Vital Signum. Pirjo Mustonen: Consultant: Roche, BMS‐Pfizer‐alliance, Novartis Finland, Boehringer Ingelheim, MSD Finland. Jari Haukka: Consultant: Research Janssen R&D; Speaker: Bayer Finland. Birgitta Salmela: Speaker (BMS, Boehringer Ingelheim, Pfizer); Advisory board (Pfizer) Miika Linna: Speaker: BMS‐Pfizer‐alliance, Bayer, Boehringer‐Ingelheim. Juha Hartikainen: Research grants: The Finnish Foundation for Cardiovascular Research, EU Horizon 2020, EU FP7. Advisory Board Member: BMS‐Pfizer‐alliance, Novo Nordisk, Amgen. Speaker: Cardiome, Bayer. K.E. Juhani Airaksinen: Research grants: The Finnish Foundation for Cardiovascular Research; Speaker: Bayer, Pfizer and Boehringer‐Ingelheim. Member in the advisory boards: Bayer, Pfizer and AstraZeneca. Mika Lehto: Consultant: BMS‐Pfizer‐alliance, Bayer, Boehringer‐Ingelheim, and MSD; Speaker: BMS‐Pfizer‐ alliance, Bayer, Boehringer Ingelheim, MSD, Terve Media and Orion Pharma. Research grants: Aarne Koskelo Foundation, The Finnish Foundation for Cardiovascular Research, and Helsinki and Uusimaa Hospital District research fund, Boehringer‐Ingelheim. Publisher Copyright: {\textcopyright} 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.",
year = "2024",
month = jan,
doi = "10.1111/eci.14107",
language = "English",
volume = "54",
journal = "European Journal of Clinical Investigation",
issn = "0014-2972",
publisher = "Wiley-Blackwell",
number = "1",
}