Key result
Oral anticoagulant use in high-risk hospitalized patients with nonvalvular atrial fibrillation was only 11.5%, and lower in second-level versus third-level hospitals (5.8% vs. 16.9%, P<0.001).
Why the study?
What is the use rate of oral anticoagulants in hospitalized patients with nonvalvular atrial fibrillation in Southwest China?
Cross-Sectional (n=3,785)
Yes
What is the use rate of oral anticoagulants in hospitalized patients with nonvalvular atrial fibrillation in Southwest China?
Absolute Event Rate: 5.8% vs 16.9%
p-value: p=<0.001
There is severe underuse of oral anticoagulation therapy in high-risk hospitalized patients with nonvalvular atrial fibrillation in Southwest China, particularly in lower-tier hospitals.
Persistent underuse of OACs in high-risk NVAF in Southwest China, especially lower-tier hospitals; leaves open the need for implementation studies to address barriers.
Background: Oral anticoagulants (OACs) are effective for the prophylaxis of stroke in patients with atrial fibrillation (AF). This cross-sectional study aimed to investigate the status of anticoagulation treatment for hospitalized AF patients in Southwest China. Methods: A total of 4760 hospitalized patients with AF were enrolled from 21 hospitals in Chongqing city from January 1 to December 31, 2013. Results: Among the enrolled patients, 3785 were diagnosed with nonvalvular AF. These patients had a mean age of 74.4±10.1 years. The mean CHADS 2 score of all subjects was 2.60±1.34, and 80.7% of the patients had CHADS 2 ≥2. The use rate of OACs was only 11.5% for patients with a high risk for stroke (CHADS 2 ≥2) and was much lower in patients from the second-level hospitals than in patients from the third-level hospitals (5.8% vs. 16.9%, P <0.001). The leading reason for the underuse of OACs in high-risk patients was physician’s nonfeasance. Conclusion: This study demonstrated that the underuse of anticoagulation therapy in hospitalized patients with nonvalvular AF was particularly serious in Southwest China, especially in the second-level hospitals. Urgent and effective measures are desperately needed to improve this alarming situation in China.
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Zheng et al. (2017) conducted a cross-sectional in nonvalvular atrial fibrillation (n=3,785). Oral anticoagulants was evaluated on Use rate of oral anticoagulants in patients with a high risk for stroke (CHADS 2 ≥2) (p=<0.001). Oral anticoagulant use in high-risk hospitalized patients with nonvalvular atrial fibrillation was only 11.5%, and lower in second-level versus third-level hospitals (5.8% vs. 16.9%, P<0.001).
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