Anticoagulant therapy for atrial fibrillation and high risk of thromboembolic events in certain Russian regions in 2023

Aim. To conduct a retrospective analysis of anticoagulation prescription rate, including direct oral anticoagulants (DOAC), to patients with atrial fibrillation and high risk of thromboembolic events (TEEs) in certain Russian regions as of December 31, 2023.

Material and methods. The analyzed group of patients was formed based on the information contained in the Webiomed predictive analytics platform (OOO K-Sky, Petrozavodsk, Russia). The information was presented as the extracted depersonalized anonymized data from the electronic health records of patients aged ≥18 years, attached to medical facilities of 17 Russian subjects (n=107561, men 37,8%, mean age 74,5±8,5 years, mean CHA₂DS₂-VASc score of 3,6±1,2) extracted by the continuous sampling method.

Results. Anticoagulation prescription rate in the group as a whole was 53,7%, while the DOAC share in its structure was 87,0%. Acetylsalicylic acid for TEE prevention was prescribed in 10,6% of cases. With an increase of non-gender-specific CHA₂DS₂-VASc score, the percentage of people receiving anticoagulation increased — from 49,7% with 2 points to 73,9% with 8 points. Anticoagulation was prescribed to patients aged ≥75 years significantly less often (49,1%, p<0,001). Regardless of age and type of arrhythmia, anticoagulants were prescribed to men significantly more often than to women.

Conclusion. The results of retrospective analysis indicate improvement in anticoagulation prescription rate for atrial fibrillation and a high risk of TEEs in certain Russian regions. Compared to a similar study for 2016-2019, in 2023 this indicator increased from 34,8% to 53,7%. The share of DOACs in anticoagulant therapy structure also increased significantly — from 52,0% to 87,0%. At the same time, oral anticoagulation rate in this cohort of patients still does not meet the requirements of current clinical guidelines.

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