Document Detail

Oral anticoagulant use in patients with atrial fibrillation
MedLine Citation:
PMID:  19553738     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Oral anticoagulant therapy has been shown to decrease the risk for vascular complications in patients with atrial fibrillation (AF). We evaluated the frequency of oral anticoagulant use in patients with AF, whether oral anticoagulant use was associated with effective INR values, and the reasons for not including an anticoagulant in the treatment. STUDY DESIGN: The study included 426 consecutive patients (256 women, 170 men; mean age 66+/-11 years) who presented with a diagnosis of AF between October 2007 and November 2008. The patients were inquired about whether they were using warfarin and/or aspirin and the reasons for not taking an oral anticoagulant. The INR levels were measured in those receiving warfarin. RESULTS: Permanent AF was present in 72.8%, and paroxysmal AF was present in 27.2%. Patients = or >75 years of age accounted for 32.4%. The risk for stroke was high in 69.3%, moderate in 21.8%, and low in 8.9%, hypertension being the most frequent risk factor (66.7%). Inquiry about medications showed that 107 patients (25.1%) were taking aspirin and warfarin, 21 patients (4.9%) and 237 patients (55.6%) were taking warfarin and aspirin alone, respectively, while 61 patients (14.3%) used none. The incidence of oral anticoagulant use was 30.1%, being significantly low in patients = or >75 years of age (p=0.0001), and having hypertension (p=0.023) or coronary artery disease (p=0.004). Effective INR values recommended by the guidelines were attained in 47.7% (n=61) of patients receiving warfarin. Sex, age, clinical risk factors, and socioeconomic parameters were not associated with achievement of target INR values. The most frequent reason for not starting anticoagulant treatment was the low tendency of physicians to prescribe the drug (74.3%), followed by the presence of contraindications (9.8%). CONCLUSION: The most important factor for inadequate oral anticoagulant use especially in patients having a high risk for stroke is the low incidence of prescription of the drug by the physicians, suggesting low influence of the guidelines on the clinical practice.
Faruk Erta?; Hamza Duygu; Halit Acet; Nihan Kahya Eren; Cem Nazli; Asim Oktay Ergene
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  T?rk Kardiyoloji Derne?i ar?ivi : T?rk Kardiyoloji Derne?inin yay?n organ?d?r     Volume:  37     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-06-25     Completed Date:  2010-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  tur     Pagination:  161-7     Citation Subset:  IM    
Department of Cardiology, Atat?rk Training and Research Hospital, Izmir, Turkey.
Vernacular Title:
Atriyal fibrilasyonlu hastalarda oral antikoag?lan kullanimi.
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MeSH Terms
Anticoagulants / therapeutic use*
Aspirin / therapeutic use
Atrial Fibrillation / complications,  drug therapy*
Hypertension / complications,  drug therapy
International Normalized Ratio
Middle Aged
Practice Guidelines as Topic
Risk Factors
Stroke / epidemiology
Warfarin / therapeutic use
Reg. No./Substance:
0/Anticoagulants; 50-78-2/Aspirin; 81-81-2/Warfarin

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