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28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
[Anticoagulation in polypathological patients with atrial fibrillation]
Jesús Díez-Manglano1, Máximo Bernabeu-Wittel, Bosco Barón-Franco
1Grupo de Paciente Pluripatológico y de Enfermedad Avanzada, Sociedad Española de Medicina Interna, España. jdiez@aragon.es
Medicina Clinica
|December 4, 2012
Summary
Oral anticoagulants are underused in atrial fibrillation patients with multiple conditions, despite improving survival rates. This study highlights the need for better prescribing practices in this vulnerable population.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Atrial fibrillation is common in polypathological patients.
- Assessing oral anticoagulant use is crucial for managing stroke risk.
- Understanding factors influencing prescription is vital for patient outcomes.
Purpose of the Study:
- To evaluate oral anticoagulant (OA) utilization in patients with atrial fibrillation (AF) and multiple comorbidities.
- To determine the impact of OA on mortality and functional decline in this cohort.
Main Methods:
- Observational, prospective, multicenter study of 1,632 polypathological patients.
- Data collection included demographics, clinical status, CHADS2 score, and OA use.
- One-year follow-up assessed survival and functional status.
Main Results:
- 32.6% of patients had AF; 94.9% had high stroke risk.
- OA use was 61% for CHADS2 score ≥2, but lower in older patients and those with cognitive impairment.
- OA prescription was associated with increased one-year survival, independent of functional status.
Conclusions:
- Oral anticoagulants are underprescribed in polypathological patients with AF.
- Despite underutilization, OA is linked to improved survival in this population.
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