{"id":21905,"date":"2025-05-22T10:45:28","date_gmt":"2025-05-22T14:45:28","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21905"},"modified":"2025-06-05T10:53:29","modified_gmt":"2025-06-05T14:53:29","slug":"east-asian-immigration-and-direct-oral-anticoagulant-dosing-for-atrial-fibrillation","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/east-asian-immigration-and-direct-oral-anticoagulant-dosing-for-atrial-fibrillation\/","title":{"rendered":"East Asian immigration and direct oral anticoagulant dosing for atrial fibrillation: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Some East Asian (EA) guidelines recommend lower doses of direct oral anticoagulants (DOACs) for atrial fibrillation (AF) than in North America and Europe.<\/p>\n<p><strong>Objective<\/strong> \u2014 Investigate the association of immigration from EA with DOAC dosing and outcomes in AF.<\/p>\n<p><strong>Methods<\/strong> \u2014 Population-based cohort study using administrative databases of Ontario immigrants with AF aged \u226566 years who were dispensed DOAC prescriptions from 2012-2019. Birth country was classified as EA or not. We used multivariable logistic regression to assess the association of EA birth with DOAC dose and cause-specific hazards regression for the association of EA birth and DOAC dose with stroke\/bleeding\/death. Interaction between EA birth and DOAC dosing was studied for each outcome.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 14,421 immigrants, 3958 (27.4%) were born in EA. EA immigrants had lower odds of receiving full-dose DOACs versus non-EA immigrants (OR 0.64, 95%CI 0.58-0.69, p&lt;0.001). EA birth was not associated with a composite of hospitalization for stroke\/bleeding (HR 0.97, 95%CI 0.84-1.12, p= 0.67) nor hospitalization for stroke (HR 0.86, 95%CI 0.71-1.04, p= 0.13), but was associated with higher bleeding hazard (HR 1.15, 95%CI 1.02-1.30, p= 0.02) and lower mortality (HR 0.91, 95%CI 0.84-0.99, p= 0.04). There was no significant interaction between EA birth and DOAC dosing for stroke (p=0.41), bleeding (p=0.27), or death (p=0.33).<\/p>\n<p><strong>Conclusions<\/strong> \u2014 EA immigrants were less likely to receive full-dose DOACs and had a higher bleeding hazard, similar stroke hazard, and lower mortality risk than non-EA immigrants. There was no evidence that DOAC dosing had a differential treatment effect in EA immigrants.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Some East Asian (EA) guidelines recommend lower doses of direct oral anticoagulants (DOACs) for atrial fibrillation (AF) than in North America and Europe. Objective \u2014 Investigate the association of immigration from EA with DOAC dosing and outcomes in AF. Methods \u2014 Population-based cohort study using administrative databases of Ontario immigrants with AF aged [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[56,18],"migration-helper-qa-sample-set":[],"class_list":["post-21905","journal_article","type-journal_article","status-publish","hentry","topic-pharmacoepidemiology-and-drug-safety","topic-racialized-communities"],"acf":{"citation":"Nakajima E, Ha ACT, Qiu F, Austin PC, Jackevicius CA, Ko DT, Dorian P, Lee DS, Abdel-Qadir H. <em>Heart Rhythm<\/em>. 2025: S1547-5271(25)02500-7. Epub 2025 May 22.","source_url":"https:\/\/doi.org\/10.1016\/j.hrthm.2025.05.040","ices_scientist":[1385,1281,1146,1290,1379],"site":[6733],"research_program":[6742],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | East Asian immigration and direct oral anticoagulant dosing for atrial fibrillation: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Some East Asian (EA) guidelines recommend lower doses of direct oral anticoagulants (DOACs) for atrial fibrillation (AF) than in North\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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