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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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The Utilization of Antithrombotic Therapy in Older Australians With Atrial Fibrillation

Bridget Elise Frain1, Ronald Castelino1, Luke Bereznicki1

  • 11 Division of Pharmacy, Unit for Medication Outcomes Research and Education, Faculty of Health, School of Medicine, University of Tasmania, Hobart, Australia.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|March 20, 2016
PubMed

Insights

Oral anticoagulants are crucial for atrial fibrillation (AF) patients to prevent stroke. However, this study found anticoagulants were overused in low-risk AF patients and underused in high-risk individuals in Australia.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Oral anticoagulants are vital for preventing thromboembolic events in atrial fibrillation (AF) patients.
  • Anticoagulant underutilization in AF is a global issue, but Australian data are limited.
  • This study addresses the need for Australian-specific data on anticoagulant use in AF.

Purpose of the Study:

  • To analyze anticoagulant utilization patterns in Australian community-dwelling AF patients.
  • To assess anticoagulant use in relation to stroke and bleeding risk.
  • To evaluate the appropriateness of antithrombotic therapy in AF.

Main Methods:

  • Retrospective, nonexperimental analysis of antithrombotic usage in Australia.
  • Utilized CHADS2, CHA2DS2-VASc, and HAS-BLED scores for risk stratification.
  • Assessed appropriateness based on documented contraindications.

Main Results:

  • Anticoagulants were overutilized in low-stroke-risk AF patients.
  • Anticoagulants were underutilized in high-stroke-risk AF patients.
  • Increased HAS-BLED scores correlated with decreased anticoagulant likelihood, irrespective of stroke risk scores.

Conclusions:

  • Significant disparities exist in Australian anticoagulant prescribing for AF.
  • Current prescribing patterns do not align with established stroke and bleeding risk guidelines.
  • Optimizing anticoagulant therapy in AF patients requires addressing both over- and underutilization.
Abstract

Keywords:
anticoagulantsstrokethrombosis prophylaxis

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