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

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[What Are the Realities of Prescription and Control of Antithrombotic Therapy in Atrial Fibrillation in Outpatient

R M Linchak, O G Kompaniyets, A M Nedbaykin

    Kardiologiia
    |December 3, 2015
    PubMed

    Insights

    Anticoagulant use for stroke prevention in Russian atrial fibrillation (AF) patients is low, with suboptimal warfarin monitoring. Effective anticoagulation was achieved in only 12.6% of warfarin-treated outpatients.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Public Health

    Context:

    • Nonvalvular atrial fibrillation (AF) poses a high risk for stroke and systemic embolism.
    • Ambulatory care settings in Russia present unique challenges for managing anticoagulation.
    • Current treatment guidelines emphasize the need for effective antithrombotic therapy in AF patients.

    Purpose:

    • To evaluate the utilization and effectiveness of anticoagulant and antiplatelet therapies in outpatients with nonvalvular AF in Russia.
    • To assess the quality of anticoagulation monitoring, specifically international normalized ratio (INR) control, in patients treated with warfarin.
    • To determine the proportion of AF patients achieving persistent effective anticoagulation.

    Summary:

    • A study analyzed 648 outpatients with nonvalvular AF across three Russian cities.
    • Low rates of anticoagulant use (30.9%) and novel oral anticoagulant (NOAC) prescriptions (5.7%) were observed.
    • High proportions received antiplatelets (53.6%) or no antithrombotic therapy (13.4%).
    • Among warfarin users, only 19.6% monitored INR monthly, and 44% had INR within the therapeutic range >60% of the time.
    • Effective anticoagulation was achieved in only 12.6% of warfarin-treated patients.

    Impact:

    • Findings highlight significant gaps in stroke prevention strategies for AF patients in Russia.
    • Suboptimal anticoagulation management necessitates improved clinical practice and patient education.
    • Results underscore the need for better adherence to monitoring protocols for warfarin and potentially wider adoption of NOACs.

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