Why the study?
How do prescribing practices for anticoagulation in elderly patients with atrial fibrillation differ between geriatricians and cardiologists?
Cross-Sectional (n=600)
How do prescribing practices for anticoagulation in elderly patients with atrial fibrillation differ between geriatricians and cardiologists?
There are significant differences in attitudes toward anticoagulation for elderly AF patients between cardiologists and geriatricians, with cardiologists generally more willing to prescribe warfarin in certain conditions.
Answers are grounded in this paper and cite their sources.
Specialty differences in AF anticoagulation prescribing should not change practice; hypothesis-generating for influences on decisions in elderly patients.
The use of warfarin and aspirin for the primary prevention of stroke in elderly patients with atrial fibrillation (AF) is controversial. To establish current practice we circulated a questionnaire to 300 geriatricians (G) and 300 cardiologists (C). The response rates were 47% G and 51% C. Most physicians prescribed warfarin in AF associated with mitral stenosis (G vs C, 86% vs 89%, NS). Cardiologists were more likely to prescribe warfarin in AF associated with dilated cardiomyopathy (G vs C, 52% vs 86%, P < 0.01). A minority would prescribe warfarin in aortic valve disease and AF (G vs C, 37% vs 24%, P < 0.05) and lone AF (G vs C, 10% vs 26%, P < 0.01). Aspirin was favoured in aortic valve disease and lone AF. The cardiologists were less reluctant to use warfarin in the young and more likely to electrically cardiovert the young with chronic AF.
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King et al. (1995) conducted a cross-sectional in Atrial fibrillation in the elderly (n=600). Geriatrician specialty vs. Cardiologist specialty was evaluated on Prescription of warfarin in AF associated with dilated cardiomyopathy (p=< 0.01).
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