Antithrombotics are blood thinning medications that are used to treat a range of cardiovascular diseases.
Atrial fibrillation (AF) is one such disease, and is the most common disturbance of heart rhythm and a common cause of stroke.
In individuals who have AF, antithrombotics (AT) are used to lower stroke risk. However, around a third of those with AF are not on the most effective type of AT or take no medication at all.
New evidence is emerging that individuals already taking AT medication (whether for AF or for another disease) may have improved outcomes if they become infected with COVID-19. However, the evidence for a protective association between AT and COVID-19 remains inconclusive.
This study, therefore, set out to conduct the largest scale evaluation of AT use in individuals with AF to date in routinely updated, linked, population-scale electronic health record (EHR) data for 56 million people in England. Utilising this statistical power, this study investigated what factors are associated with pre-existing AT use and whether pre-existing AT use (across sub-types) may reduce COVID-19 related hospitalisation and death.
In addressing these questions, this project will create the software to automatically evaluate antithrombotic use in near real-time across the whole UK population. This will provide the information to help ensure individuals with AF are given the most effective treatments and confirm whether antithrombotics offer some protection against COVID-19.
Handy A, Banerjee A, Wood AM on behalf of the CVD-COVID-UK Consortium, et al. Evaluation of antithrombotic use and COVID-19 outcomes in a nationwide atrial fibrillation cohort. Heart Published Online First: 10 March 2022. doi: 10.1136/heartjnl-2021-320325
Analysis code and supporting materials (e.g. phenotype codelists, protocol) are available in the "/england" folder.
A web dashboard with summary results is available here
This project has been approved by the CVD-COVID-UK / COVID-IMPACT Approvals & Oversight Board (Project ID: CCU020).
Licensed under the Apache License, Version 2.0 (the "License"); you may not use this software except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0. Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an "AS IS" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License.