Document Detail

Physicians' attitudes and the use of oral anticoagulants: surveying the present and envisioning future.
MedLine Citation:
PMID:  14760209     Owner:  NLM     Status:  MEDLINE    
Atrial fibrillation has the highest prevalence in the elderly. While the elderly are at the highest risk for stroke and would benefit the most from anticoagulation, they are also the least likely to receive anticoagulation. In a pooled analysis of the primary prevention trials, warfarin reduced stroke by 68% compared with placebo, and aspirin reduced stroke by 18%. Age, history of hypertension, diabetes, heart failure or reduced left ventricular function, and previous transient ischemic events and stroke are independent risk factors for stroke in patients with atrial fibrillation. Less than 50% of the elderly who have clear-cut indications and no contraindications for warfarin receive anticoagulant therapy. This low use of warfarin is driven by many factors, but physicians' fear of hemorrhage is among the most important. Better adherence to evidence-driven guidelines, better patient and physician education, point-of-care monitoring of INR and the future development of user friendly anticoagulant drugs are likely to result in higher rates of anticoagulation use.
Meghan York; Ashish Agarwal; Michael Ezekowitz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  16     ISSN:  0929-5305     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:    2003 Aug-Oct
Date Detail:
Created Date:  2004-02-04     Completed Date:  2004-11-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  33-7     Citation Subset:  IM    
Drexel University College of Medicine, Philadelphia, PA 19102, USA.
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MeSH Terms
Administration, Oral
Anticoagulants / administration & dosage*,  adverse effects
Atrial Fibrillation / drug therapy
Attitude of Health Personnel*
Physician's Role*
Reg. No./Substance:

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