What question did this study set out to answer?

To determine the proportion of patients with atrial fibrillation who were not receiving antithrombotic therapy before stroke onset and identify clinical characteristics associated with prior treatment.

November 1, 1999HeartOpen Access

Stroke and atrial fibrillation: is stroke prevention treatment appropriate beforehand?

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Why the study?

What proportion of patients with atrial fibrillation admitted for acute stroke or TIA were receiving appropriate prior antithrombotic treatment?

Population

213 patients with atrial fibrillation consecutively admitted for an acute stroke or transient ischaemic…

Comparison

Prior antithrombotic treatment vs No prior antithrombotic treatment

Design

Cross-sectional

Authors

DDDominique DeplanqueInserm FCFrancesco CoreaUniversity of Campania "Luigi Vanvitelli"CACaroline ArquizanInserm

Discussion

Member takes

Implication

Marked undertreatment of eligible AF patients before stroke cautions against complacency; leaves open whether contemporary strategies have closed this gap.

Key Points

To determine the proportion of patients with atrial fibrillation who were not receiving antithrombotic therapy before stroke onset and identify clinical characteristics associated with prior treatment.
Conducted an observational multicentre pilot study (SAFE I) involving N=213 consecutive patients with atrial fibrillation admitted for acute stroke or transient ischaemic attack across three European centres in 1997.
Assessed prior antithrombotic therapy use, therapeutic international normalised ratio (INR) levels, and performed logistic regression to identify independent factors associated with treatment.
Atrial fibrillation was known prior to stroke in 69.5% of patients (n=148), but only 16.0% (n=34) were receiving anticoagulation—with just 6 achieving an INR between 2.0 and 3.5—while 30.5% (n=65) received antiplatelet therapy.
Among treatment-eligible cohorts, 78.8% (108/137) did not receive oral anticoagulation and 43.7% (62/142) did not receive any antithrombotic therapy beforehand.
Anticoagulation independently associated with digoxin treatment, absence of arterial hypertension, mitral stenosis, and cardioversion, whereas any antithrombotic therapy associated with known AF, younger age, non-smoking, and no hypertension.

Structured PICO

What proportion of patients with atrial fibrillation admitted for acute stroke or TIA were receiving appropriate prior antithrombotic treatment?

Population

213 patients with atrial fibrillation consecutively admitted for an acute stroke or transient ischaemic attack (TIA) across three European centres.

Intervention

Prior antithrombotic treatment (anticoagulation or antiplatelet therapy)

Comparator

No prior antithrombotic treatment

Outcome

Proportion of patients with atrial fibrillation not receiving antithrombotic treatment before stroke onset

A significant proportion of patients with atrial fibrillation who suffer a stroke or TIA are not receiving guideline-recommended antithrombotic therapy prior to the event.

Cite This Study

Deplanque et al. (1999) studied this question.

synapsesocial.com/papers/6a7316c94499ffee882b2e8a https://doi.org/10.1136/hrt.82.5.563

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management Dual antiplatelet therapy

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Implication

Marked undertreatment of eligible AF patients before stroke cautions against complacency; leaves open whether contemporary strategies have closed this gap.

Stroke and atrial fibrillation: is stroke prevention treatment appropriate beforehand?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Stroke and atrial fibrillation: is stroke prevention treatment appropriate beforehand?

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider