Antithrombotic Therapy Underutilization in Patients With Atrial Flutter.

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• Oral anticoagulant (OAC) therapy underutilization is common in atrial fibrillation, but less studied in atrial flutter (AFL).
• Studies on OAC utilization patterns and influencing factors in AFL patients are scarce.
• This research addresses the gap by examining OAC use in South Korean AFL patients.

Purpose of the Study:

• To investigate the utilization of OAC therapy in South Korean patients with atrial flutter (AFL).
• To identify factors influencing OAC therapy underutilization in AFL patients.
• To determine the types and percentages of anticoagulants used in this population.

Main Methods:

• Analysis of Aged Population Sample data (2011-2015) from the Health Insurance Review & Assessment Service.
• Identification of AFL patients (KCD-6 code I48.1) at high stroke risk and low bleeding risk.
• Logistic regression used to investigate demographic and clinical factors associated with OAC therapy underutilization (estimated by ACU scales).

Main Results:

• The mean anticoagulant underutilization (ACU) value was 67.4% between 2011 and 2015.
• Positive risk factors for ACU included female sex, aspirin use, and limited anticoagulant options.
• Negative risk factors for ACU comprised comorbidities (e.g., heart failure, valvular heart disease) and a history of stroke/TIA.

Conclusions:

• A significant majority (two-thirds) of South Korean AFL patients did not receive adequate stroke prevention via OACs.
• OAC underutilization was more pronounced in female patients and those concurrently using aspirin.
• The findings underscore a persistent challenge in achieving optimal stroke prevention for AFL patients, even with modern OACs available.