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Thank you for attending THSNA 2026. The virtual meeting is now closed.
Thank you for attending THSNA 2026. The virtual meeting is now closed.
Presentation Details
| Disparities in Anticoagulation Prescribing Across Different Race/Ethnicities Annjay Tabbilos, Joe Mazur, Sienna Miller, Jennifer Mazur, Julie Ann Ehret, Joli Fermo, Agnes Musyoka, Emily Overly. Medical University of South Carolina, Charleston, SC, USA |
Abstract
Background: Within recent years, American Society of Hematology (ASH) and American Heart Association (AHA) guidelines have recommended direct oral anticoagulants (DOACs) over warfarin for therapeutic anticoagulation in venous thromboembolism (VTE) and atrial fibrillation.1,4 In accordance with the guidelines, the trend in DOAC prescriptions has increased while warfarin prescriptions have declined.2 However, due to multiple social factors, there exists a potential for disparity in prescribing first-line therapy (DOACs) vs. warfarin. Recent studies have identified racial disparities in equitable access to DOACs in patients with atrial fibrillation.3 Our hospital system caters towards a large variety of patients differing in social and economic characteristics. This study aims to determine the healthcare disparity in the appropriateness of anticoagulation prescribing across different races/ethnicities within our hospital system. Methods: This is a retrospective single-center study for the evaluation of the appropriateness and disparity of anticoagulation prescribing in patients with atrial fibrillation and/or venous thromboembolism (VTE). Inclusion criteria were: adult patients admitted to a Charleston campus hospital from March 1, 2025 to August 31, 2025 who were newly diagnosed with atrial fibrillation and/or VTE, and who picked up their anticoagulant prescriptions from an MUSC pharmacy. Patients were excluded if they were prescribed an anticoagulant other than rivaroxaban, apixaban, or warfarin for an indication other than atrial fibrillation or VTE at an outside pharmacy. The primary outcome was the appropriateness of anticoagulation for the hospital’s primary racial groups (Caucasian/White, African American/Black, Hispanic, or other). Appropriateness was based on anticoagulation dosing, duration, and risk vs. benefit. Additional analysis will examine the difference in warfarin versus DOAC prescribing amongst the racial groups. Secondary outcomes include rehospitalization within 30 days and 60 days for thrombotic and/or bleeding events. Descriptive statistics will be used for nominal data while a Chi-squared or Fisher’s Exact test will be used for categorical variables. Results: Results will be in final presentation Conclusion: Conclusion will be in final presentation References: 1. Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193 2. Navar AM, Kolkailah AA, Overton R, et al. Trends in Oral Anticoagulant Use Among 436 864 Patients With Atrial Fibrillation in Community Practice, 2011 to 2020. J Am Heart Assoc. 2022;11(22):e026723. doi:10.1161/JAHA.122.026723 3. Reynolds KR, Khosrow-Khavar F, Dave CV. Racial and Ethnic Disparities in Initiation of Direct Oral Anticoagulants Among Medicare Beneficiaries. JAMA Netw Open. 2024;7(5):e249465. Published 2024 May 1. doi:10.1001/jamanetworkopen.2024.9465 4. Thomas L. Ortel, Ignacio Neumann, et al; American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Blood Adv 2020; 4 (19): 4693–4738. doi: https://doi.org/10.1182/bloodadvances.2020001830
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.