{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:01:25Z","timestamp":1791309685209,"version":"4.3.1"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:sec id=\"ab-hoi220062-4\"><jats:title>Importance<\/jats:title><jats:p>Oral anticoagulation (OAC) is underprescribed in underrepresented racial and ethnic group individuals with atrial fibrillation (AF). Little is known of how differential OAC prescribing relates to inequities in AF outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-5\"><jats:title>Objective<\/jats:title><jats:p>To compare OAC use at discharge and AF-related outcomes by race and ethnicity in the Get With The Guidelines\u2013Atrial Fibrillation (GWTG-AFIB) registry.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort analysis used data from the GWTG-AFIB registry, a national quality improvement initiative for hospitalized patients with AF. All registry patients hospitalized with AF from 2014 to 2020 were included in the study. Data were analyzed from November 2021 to July 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-7\"><jats:title>Exposures<\/jats:title><jats:p>Self-reported race and ethnicity assessed in GWTG-AFIB registry.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was prescription of direct-acting OAC (DOAC) or warfarin at discharge. Secondary outcomes included cumulative 1-year incidence of ischemic stroke, major bleeding, and mortality postdischarge. Outcomes adjusted for patient demographic, clinical, and socioeconomic characteristics as well as hospital factors.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-9\"><jats:title>Results<\/jats:title><jats:p>Among 69\u202f553 patients hospitalized with AF from 159 sites between 2014 and 2020, 863 (1.2%) were Asian, 5062 (7.3%) were Black, 4058 (5.8%) were Hispanic, and 59\u202f570 (85.6%) were White. Overall, 34\u202f113 (49.1%) were women; the median (IQR) age was 72 (63-80) years, and the median (IQR) CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score (calculated as congestive heart failure, hypertension, age 75 years and older, diabetes, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, and sex category) was 4 (2-5). At discharge, 56\u202f385 patients (81.1%) were prescribed OAC therapy, including 41\u202f760 (74.1%) receiving DOAC. OAC prescription at discharge was lowest in Hispanic patients (3010 [74.2%]), followed by Black patients (3935 [77.7%]) Asian patients (691 [80.1%]), and White patients (48\u202f749 [81.8%]). Black patients were less likely than White patients to be discharged while taking any anticoagulant (adjusted odds ratio, 0.75; 95% CI, 0.68-0.84) and DOACs (adjusted odds ratio, 0.73; 95% CI, 0.65-0.82). In 16\u202f307 individuals with 1-year follow up data, bleeding risks (adjusted hazard ratio [aHR], 2.08; 95% CI, 1.53-2.83), stroke risks (aHR, 2.07; 95% CI, 1.34-3.20), and mortality risks (aHR, 1.22; 95% CI, 1.02-1.47) were higher in Black patients than White patients. Hispanic patients had higher stroke risk (aHR, 2.02; 95% CI, 1.38-2.95) than White patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hoi220062-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In a national registry of hospitalized patients with AF, compared with White patients, Black patients were less likely to be discharged while taking anticoagulant therapy and DOACs in particular. Black and Hispanic patients had higher risk of stroke compared with White patients; Black patients had a higher risk of bleeding and mortality. 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