Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?

Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?

Atrial fibrillation (AF) is a very common cardiac arrhythmia, and its prevalence is increasing along with aging in the developed world. This review discusses racial differences in the epidemiology and treatment of AF between African-American and Caucasian patients. Additionally, the effect of race o...

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Main Author: Akinboboye, Olakunle
Format: Online
Language:English
Published: Dove Medical Press 2015
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445875/
id pubmed-4445875
recordtype oai_dc
spelling pubmed-44458752015-06-08 Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity? Akinboboye, Olakunle Review Atrial fibrillation (AF) is a very common cardiac arrhythmia, and its prevalence is increasing along with aging in the developed world. This review discusses racial differences in the epidemiology and treatment of AF between African-American and Caucasian patients. Additionally, the effect of race on warfarin and novel oral anticoagulant use is discussed, as well as the role that physicians and patients play in achieving optimal treatment outcomes. Despite having a lower prevalence of AF compared with Caucasians, African-Americans suffer disproportionately from stroke and its sequelae. The possible reasons for this paradox include poorer access to health care, lower health literacy, and a higher prevalence of other stroke-risk factors among African-Americans. Consequently, it is important for providers to evaluate the effects of race, health literacy, access to health care, and cultural barriers on the use of anticoagulation in the management of AF. Warfarin-dose requirements vary across racial groups, with African-American patients requiring a higher dose than Caucasians to maintain a therapeutic international normalized ratio; the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to differ in this regard, although data are currently limited. Minority racial groups are not proportionally represented in either real-world studies or clinical trials, but as more information becomes available and other social issues are addressed, the treatment disparities between African-American and Caucasian patients should decrease. Dove Medical Press 2015-05-18 /pmc/articles/PMC4445875/ /pubmed/26056467 http://dx.doi.org/10.2147/JMDH.S74529 Text en © 2015 Akinboboye. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Akinboboye, Olakunle
spellingShingle Akinboboye, Olakunle
Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
author_facet Akinboboye, Olakunle
author_sort Akinboboye, Olakunle
title Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
title_short Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
title_full Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
title_fullStr Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
title_full_unstemmed Use of oral anticoagulants in African-American and Caucasian patients with atrial fibrillation: is there a treatment disparity?
title_sort use of oral anticoagulants in african-american and caucasian patients with atrial fibrillation: is there a treatment disparity?
description Atrial fibrillation (AF) is a very common cardiac arrhythmia, and its prevalence is increasing along with aging in the developed world. This review discusses racial differences in the epidemiology and treatment of AF between African-American and Caucasian patients. Additionally, the effect of race on warfarin and novel oral anticoagulant use is discussed, as well as the role that physicians and patients play in achieving optimal treatment outcomes. Despite having a lower prevalence of AF compared with Caucasians, African-Americans suffer disproportionately from stroke and its sequelae. The possible reasons for this paradox include poorer access to health care, lower health literacy, and a higher prevalence of other stroke-risk factors among African-Americans. Consequently, it is important for providers to evaluate the effects of race, health literacy, access to health care, and cultural barriers on the use of anticoagulation in the management of AF. Warfarin-dose requirements vary across racial groups, with African-American patients requiring a higher dose than Caucasians to maintain a therapeutic international normalized ratio; the novel oral anticoagulants (dabigatran, rivaroxaban, and apixaban) seem to differ in this regard, although data are currently limited. Minority racial groups are not proportionally represented in either real-world studies or clinical trials, but as more information becomes available and other social issues are addressed, the treatment disparities between African-American and Caucasian patients should decrease.
publisher Dove Medical Press
publishDate 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445875/
_version_ 1613228328963014656

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