Background: The reported anticoagulation rate may be overestimated
among Chinese patients with atrial fibrillation (AF). Therefore, we aimed to
understand the current status and time trends of anticoagulation among older
people in the Chinese community. Methods: Data were obtained from the
physical examination program for the elderly (aged 65 years) in
Guangzhou. During 2017–2020, a total of 31,829, 58,573, 55,483, and 54,845 older
people underwent annual physical examinations, respectively, where their general
information, AF-related medical history, and use of oral anticoagulants (OACs)
were collected for analysis. Results: From 2017 to 2020, the estimated
annual prevalence of older people with nonvalvular atrial fibrillation (NVAF) in
Guangzhou was 0.99%, 0.92%, 1.05%, and 1.14%, respectively. In patients with
high stroke risk (CHA2DS2-VASc score 2 for males or 3 for
females), the annual anticoagulation rates were 2.83%, 2.05%, 5.29%, and
5.82%, respectively. The proportion of NVAF patients prescribed non-vitamin K
antagonist oral anticoagulants (NOACs) increased gradually over the same period
(p = 0.004). Males (odds ratios (OR), 1.797; 95% confidence interval
(CI), 1.169–2.763; p = 0.008), ages over 75 (OR, 1.858; 95% CI,
1.212–2.849; p = 0.005), low education levels (OR, 1.737; 95% CI,
1.132–2.665; p = 0.011), and lacking the ability for self-care (OR,
4.432; 95% CI, 1.067–18.418; p = 0.041) were less likely to receive
OAC therapy. Conclusions: The low anticoagulation rate of older people
with NVAF in the Chinese community has not significantly improved in recent
years, with only 5.82% of patients with high stroke risk being prescribed OACs.
Therefore, it is necessary to establish an appropriate mode of anticoagulant
management to improve the current situation.