Mental Health Conditions and Nonpersistence of Direct Oral Anticoagulant Use in Patients With Incident Atrial Fibrillation : A Nationwide Cohort Study

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Teppo , K , Jaakkola , J , Airaksinen , K E J , Biancari , F , Halminen , O , Putaala , J , Mustonen , P , Haukka , J , Hartikainen , J , Luojus , A , Niemi , M , Linna , M & Lehto , M 2022 , ' Mental Health Conditions and Nonpersistence of Direct Oral Anticoagulant Use in Patients With Incident Atrial Fibrillation : A Nationwide Cohort Study ' , Journal of the American Heart Association , vol. 11 , no. 6 , 024119 . https://doi.org/10.1161/JAHA.121.024119

Title: Mental Health Conditions and Nonpersistence of Direct Oral Anticoagulant Use in Patients With Incident Atrial Fibrillation : A Nationwide Cohort Study
Author: Teppo, Konsta; Jaakkola, Jussi; Airaksinen, K. E. Juhani; Biancari, Fausto; Halminen, Olli; Putaala, Jukka; Mustonen, Pirjo; Haukka, Jari; Hartikainen, Juha; Luojus, Alex; Niemi, Mikko; Linna, Miika; Lehto, Mika
Contributor organization: HUS Heart and Lung Center
HUS Neurocenter
Clinicum
Department of Neurosciences
Neurologian yksikkö
Jari Haukka / Principal Investigator
Department of Public Health
Faculty of Medicine
HUSLAB
Department of Clinical Pharmacology
Medicum
INDIVIDRUG - Individualized Drug Therapy
HUS Diagnostic Center
Date: 2022-03-15
Language: eng
Number of pages: 14
Belongs to series: Journal of the American Heart Association
ISSN: 2047-9980
DOI: https://doi.org/10.1161/JAHA.121.024119
URI: http://hdl.handle.net/10138/342686
Abstract: BACKGROUND: Mental health conditions (MHCs) are associated with poor outcomes in patients with atrial fibrillation. However, persistence of oral anticoagulation therapy in patients with atrial fibrillation and MHCs is unknown. We aimed to evaluate the effect of MHCs on the persistence of direct oral anticoagulant (DOAC) use in patients with atrial fibrillation based on a nationwide cohort. METHODS AND RESULTS: The nationwide registry-based FinACAF (Finnish Anticoagulation in Atrial Fibrillation) cohort included 67 503 patients with incident atrial fibrillation and indication for permanent oral anticoagulation (CHA(2)DS(2)-VASc score >1 in men and >2 in women) starting DOAC therapy between 2011 and 2018. MHCs of interest were depression, bipolar disorder, anxiety disorder, schizophrenia, and composite of any MHC. The main outcome was nonpersistence of DOAC use, defined as the first 120-day period without DOAC purchases after drug initiation. The mean age of the patients was 75.3 +/- 8.9 years, 53.6% were women, and the prevalence of any MHC was 17.8%. Persistence after 1 year from DOAC initiation was 79.3% in patients without MHCs and 77.2% in patients with any MHC, and after 2 years were 64.4% and 60.6%, respectively (P CONCLUSIONS: MHCs are associated with nonpersistence of DOAC use.
Subject: atrial fibrillation
depression
direct oral anticoagulants
mental health conditions
persistence
ADHERENCE
PERSISTENCE
METAANALYSIS
THERAPY
WARFARIN
STROKE
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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