Related Experiment Video
Updated: May 5, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
84.2K
Stroke prophylaxis in atrial fibrillation: who gets it and who does not? Report from the Stockholm Cohort-study on
Leif Friberg1, Niklas Hammar, Mattias Ringh
1Karolinska Institute at South Hospital, Stockholm, Sweden. leif.friberg@stockholm.bonet.se
European Heart Journal
|July 19, 2006
Summary
Warfarin underuse for stroke prevention in atrial fibrillation (AF) is common. Eligible AF patients, especially those with paroxysmal AF or over 80, often do not receive warfarin, highlighting a need for improved clinical practice.
Area of Science:
- Cardiology
- Clinical Practice
- Pharmacotherapy
Background:
- Warfarin is a crucial anticoagulant for stroke prevention in atrial fibrillation (AF).
- Underuse of warfarin in eligible AF patients is a significant clinical challenge.
- Identifying factors influencing warfarin prescription is essential for optimizing patient care.
Purpose of the Study:
- To identify factors associated with warfarin treatment in patients with atrial fibrillation (AF).
- To understand the extent of warfarin underuse in a real-world clinical setting.
Main Methods:
- Retrospective analysis of 2796 Swedish resident AF patients from 2002.
- Data collected from medical records and the Swedish National Hospital Discharge Register.
- Statistical analysis to identify factors favoring or reducing warfarin treatment.
Main Results:
- 54% of eligible AF patients (1029/1898) received warfarin.
- History of stroke, pacemakers, cardiology ward treatment, and valvular defects favored warfarin use.
- Paroxysmal AF and age over 80 were associated with reduced warfarin likelihood; common stroke risk factors like heart failure, hypertension, and diabetes did not increase warfarin use.
Conclusions:
- Stroke risk stratification appears to have a minor impact on warfarin treatment decisions.
- Undertreatment is prevalent in paroxysmal AF and elderly patients (>80 years).
- Clinical routines require enhancement to align with international guidelines for AF stroke prophylaxis.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.6K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.6K
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.8K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.8K
01:26Coronary Artery Disease IV: Preventive Measures
891
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
891
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
01:29Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
760
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
760