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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Newly detected atrial fibrillation and compliance with antithrombotic guidelines

Nicole L Glazer1, Sascha Dublin, Nicholas L Smith

  • 1Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, 1730 Minor Avenue, Seattle, WA 98101, USA. nlg@u.washington.edu

Archives of Internal Medicine
|February 14, 2007
PubMed

Insights

Most patients with newly detected atrial fibrillation (AF) received antithrombotic therapy. However, warfarin use in high-risk patients was influenced more by AF classification than stroke risk factors.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Guidelines recommend antithrombotic therapy for stroke prevention in atrial fibrillation (AF).
  • Compliance with these guidelines in newly detected AF is not well-studied.
  • Need to identify patient characteristics associated with warfarin use.

Purpose of the Study:

  • Assess compliance with antithrombotic guidelines in newly detected AF.
  • Identify patient characteristics associated with warfarin use.

Main Methods:

  • Population-based study of newly detected AF (ages 30-84) within a large health plan.
  • Abstracted cardiovascular risk factors, comorbidities, and medication use.
  • Stratified patients by embolic risk (ACCP criteria) and analyzed antithrombotic use (warfarin/aspirin) within 6 months post-AF onset.
  • Used relative risk regression to associate risk factors with warfarin use.

Main Results:

  • 73% of patients with newly detected AF received antithrombotic therapy.
  • Among high-risk patients (76%), 59% used warfarin, 28% used aspirin, and 24% used neither.
  • AF classification (intermittent/sustained) was a major predictor of warfarin use (RR 2.8-2.9) compared to transitory AF.

Conclusions:

  • Three-quarters of patients with newly detected AF received antithrombotic therapy.
  • Many high-risk patients did not receive warfarin.
  • AF classification, not stroke risk factors, strongly predicted warfarin use.
Abstract

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