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[Antithrombotic treatment of atrial fibrillation in hospital]
G Thomassen1, M S Hansen, A Nordøy
1Medisinsk avdeling Regionsykehuset i Tromsø 9038 Tromsø. johnbh@fagmed.uit.no
Insights
This study found that hospital practices generally follow guidelines for prescribing antithrombotic treatments, such as warfarin, to patients with chronic atrial fibrillation. Adherence to these recommendations was observed in clinical practice.
Area of Science:
- Cardiology
- Clinical Practice Guidelines
- Pharmacotherapy
Context:
- Clinical guidelines recommend oral anticoagulation for atrial fibrillation patients over 65 or with risk factors.
- Investigated adherence to these recommendations in real-world clinical settings.
Purpose:
- To evaluate the implementation of oral anticoagulation guidelines in patients with atrial fibrillation.
- To assess antithrombotic treatment patterns in hospitalized atrial fibrillation patients.
Summary:
- A retrospective study of 362 atrial fibrillation patients (mean age 68.4) found 70% of those with chronic atrial fibrillation received warfarin at discharge.
- Warfarin prescription was predicted by prior stroke and atrial fibrillation, but not age.
- 20% received aspirin, and 12% received no antithrombotic treatment.
Impact:
- Demonstrates high adherence to antithrombotic treatment guidelines for chronic atrial fibrillation in hospital settings.
- Highlights the importance of considering patient history for warfarin prescription.
- Suggests a need for continued monitoring of antithrombotic therapy in atrial fibrillation management.
Background:
In clinical guidelines regarding atrial fibrillation, oral anticoagulation is recommended for patients over the age of 65 or with additional risk factors. The aim of the present study was to investigate how these recommendations are followed in clinical practice.
Material And Methods:
A retrospective study was conducted among patients hospitalized for atrial fibrillation at Tromsø University Hospital from 1995 to 1998. Data were obtained from hospital files.
Results:
362 patients with atrial fibrillation (57% men), mean age 68.4 years (range 24-96), were included. 23.5% had their first atrial fibrillation event. 224 (62%) patients experienced successful cardioversion during hospitalization(s), while 138 (38%) were discharged from hospital with chronic atrial fibrillation. 97 (70%) of these patients were given warfarin at discharge. Previous stroke and atrial fibrillation were significant predictors for warfarin prescription. Prescription did not increase with age. 28 (20%) of patients with chronic atrial fibrillation received acetylsalicylic acid, while 16 (12%) were not given antithrombotic treatment.
Interpretation:
This study indicates a high degree of implementation of guidelines for antithrombotic treatment of patients with chronic atrial fibrillation in hospital practice.