| Title |
Patient Diversity and Population Health-Related Cardiovascular Outcomes Associated with Warfarin Use in Atrial Fibrillation: An Analysis Using Administrative Claims Data
|
|---|---|
| Published in |
Advances in Therapy, September 2018
|
| DOI | 10.1007/s12325-018-0782-1 |
| Pubmed ID | |
| Authors |
Michael H. Kim, Liou Xu, Gary Puckrein |
| Abstract |
Anticoagulants are effective for stroke prevention in atrial fibrillation (AF). Data on population health-related cardiovascular outcomes by race/ethnicity and gender are not well described. The aim was to assess the impact of patient diversity on associated cardiovascular outcomes related to warfarin anticoagulation in Medicare beneficiaries with AF. Medicare administrative claims data for years 2000-2010 were used to calculate AF prevalence and rates of new AF cases. Three 20% sample cohorts of new AF beneficiaries for years 2000, 2005, and 2007 were extracted and analyzed in a longitudinal study design. The impact of warfarin on associated cardiovascular outcomes was measured with respect to race/ethnicity and gender. Measured outcomes included the risk of stroke, mortality and hospitalization after adjusting for age, gender, race/ethnicity, CHADS2 score and warfarin. AF prevalence and warfarin use increased while stroke and mortality rates declined across race/ethnicity and gender from 2000 to 2010. Analyses comparing Whites to non-Whites highlighted several disparities: (1) Blacks were 40% (p < 0.0001) more likely to have a stroke even after adjustment for warfarin; (2) in 2007, Hispanics had a 35% (p < 0.01) higher prevalence of stroke and warfarin did not reduce the risk; and (3) Asians had better outcomes. Warfarin reduced stroke less well in women who had a lower risk of death and hospitalization. Despite a > 70% (p < 0.0001) reduction in mortality for warfarin users, Blacks had a 25% (p < 0.0001) higher mortality risk than Whites. Differences in population health metrics across race/ethnicity and gender exist in AF. Across all metrics, Blacks had comparatively worse outcomes. Patient diversity should be a focus for future investigations in AF to improve outcomes in the whole population. National Minority Quality Forum. |
X Demographics
The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 25% |
| Canada | 1 | 25% |
| Unknown | 2 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 2 | 50% |
| Members of the public | 2 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 3 | 11% |
| Student > Bachelor | 3 | 11% |
| Other | 2 | 7% |
| Librarian | 2 | 7% |
| Student > Ph. D. Student | 2 | 7% |
| Other | 5 | 19% |
| Unknown | 10 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 33% |
| Nursing and Health Professions | 3 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
| Psychology | 1 | 4% |
| Agricultural and Biological Sciences | 1 | 4% |
| Other | 2 | 7% |
| Unknown | 10 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 September 2018.
All research outputs
#13,260,387
of 23,103,436 outputs
Outputs from Advances in Therapy
#948
of 2,384 outputs
Outputs of similar age
#164,363
of 337,900 outputs
Outputs of similar age from Advances in Therapy
#19
of 55 outputs
Altmetric has tracked 23,103,436 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,384 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one has gotten more attention than average, scoring higher than 60% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,900 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
We're also able to compare this research output to 55 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.