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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Evaluation of Adherence to Guideline-Directed Antithrombotic Therapy for Atrial Fibrillation at Hospital Discharge

Lori Dupree1, Marci DeLosSantos2, Carmen Smotherman3

  • 11 Department of Pharmacotherapy and Translational Research, University of Florida College of Pharmacy, UF Health Jacksonville, FL, USA.

Journal of Cardiovascular Pharmacology and Therapeutics
|May 29, 2018
PubMed

Insights

Most atrial fibrillation patients receive appropriate stroke prevention therapy. However, withholding anticoagulation due to fall risk needs reconsideration, given its benefits in preventing atrial fibrillation stroke.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) necessitates risk stratification for stroke prevention.
  • Antithrombotic therapy is crucial for managing AF-related stroke risk.

Purpose of the Study:

  • To assess adherence to guideline-directed antithrombotic therapy in atrial fibrillation (AF) patients upon hospital discharge.
  • To evaluate therapy adherence based on the CHA₂DS₂-VASc score.

Main Methods:

  • Retrospective analysis of 293 AF patients discharged between June 2014 and June 2016.
  • Collected demographic data, CHA₂DS₂-VASc scores, and reasons for withholding antithrombotic therapy (e.g., bleeding risk, falls).

Main Results:

  • 63% of AF patients received appropriate antithrombotic therapy at discharge; 50% had a CHA₂DS₂-VASc score ≥2.
  • When documented reasons for withholding anticoagulation were considered appropriate, 81% of patients were on suitable therapy (OR: 1.57, P < .0001).
  • Bleeding risk and falls were the primary reasons for withholding anticoagulation.

Conclusions:

  • The majority of AF patients are discharged on appropriate antithrombotic therapy based on CHA₂DS₂-VASc risk stratification.
  • Reconsideration of withholding anticoagulation due to fall risk is recommended, balancing benefits against stroke prevention in AF.
Abstract

Keywords:
CHA2DS2–VASc scoreanticoagulationantiplatelet therapyatrial fibrillation < heart diseasestroke

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