Key result
In a retrospective analysis of 500 stroke unit admissions, atrial fibrillation accounted for 28% of strokes, and 68% of patients with known AF were inadequately anticoagulated at presentation.
Observational (n=500)
No
A significant proportion of ischaemic strokes are related to atrial fibrillation, and the majority of these patients are inadequately anticoagulated prior to presentation despite lacking contraindications.
Inadequate anticoagulation in known AF signals missed prevention opportunities; leaves open optimal real-world strategies to reduce AF-related strokes.
BACKGROUND: Atrial fibrillation (AF) is an important predisposing factor for ischaemic stroke. There is evidence to suggest that even in appropriate candidates warfarin therapy is underutilized. We assessed the prevalence of AF in an Australian stroke unit to determine the degree of undertreatment at presentation. METHODS: A retrospective analysis of all patients admitted to our Stroke Unit between October 2004 and September 2006 was carried out. All patients with a diagnosis of AF, either new or old, were then selected from this group to determine the overall prevalence and anticoagulation status. Data regarding prior stroke, stroke severity and discharge anticoagulation status were also determined. RESULTS: Data from a total of 500 patients were analysed. Our results showed that AF-related strokes accounted for a large proportion (28%) of all admissions and were associated with a larger neurological deficit. Most patients (68%) with a prior diagnosis of AF without having obvious contraindications were either not anticoagulated or under-anticoagulated when presenting with an ischaemic stroke or transient ischaemic attack. CONCLUSION: Our results stress the importance of initiating and maintaining anticoagulation in patients with AF and without obvious contraindications to minimize the risk of subsequent stroke.
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Ahmad et al. (2009) conducted an observational in Stroke and Atrial Fibrillation (n=500). Prior diagnosis of atrial fibrillation was evaluated on Prevalence of AF and anticoagulation status at presentation. In a retrospective analysis of 500 stroke unit admissions, atrial fibrillation accounted for 28% of strokes, and 68% of patients with known AF were inadequately anticoagulated at presentation.
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