This study highlights a significant underuse of oral anticoagulation therapy and poor INR control among eligible patients with atrial fibrillation in a real-world setting.
Background Atrial fibrillation is associated with substantial mortality and morbidity from stroke and thromboembolism. Despite an efficacious oral anticoagulation, atrial fibrillation patients at high risk for stroke are often under-treated. Objectives To detect the percentage of anticoagulant eligible patients with atrial fibrillation not receiving anticoagulant therapy and its causes, and whether the INR target is reached or not. Materials and Methods A cross-sectional study in the medical emergency department and neurology unit of Shar hospital in Slemani city was carried out, from the 1st of Jan 2017 to the 1st of Dec 2017, on a sample of two hundred and seventy-two patients with atrial fibrillation. Data were obtained from the patient’s case notes for their personal detail including age, sex, history of hypertension, diabetes mellitus, vascular disease, heart failure, and thromboembolism. Results Two hundred seventy-two patients diagnosed with atrial Atrial Fibrillation, 148 (54.4%) females 124 (45.6%) males, mean age 70.43 years were analyzed and among these patients, 24 had valvular AF and 248 had no valvular AF patients. Warfarin was prescribed in 54(19.85%), antiplatelet in 63 (23.16%) patients, new oral anticoagulant in 19 (6.98%) patients and no antithrombotic therapy in 136 (50%) patients. The common cause behind why most patients with AF were not prescribed anticoagulants was; not prescribed by a physician 107 (53.76%) patients. Regarding those patients prescribed warfarin only 26 (48.1) patients INR level was in the therapeutic range. Conclusion This study demonstrates underuse of oral anticoagulation therapy for atrial fibrillation patients with high risk of stroke.
Karem et al. (Mon,) studied this question.