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October 3, 2026Circulation
Impact of Undertreated Antithrombotic Therapy on Adverse Patient Outcomes: A Scientific Statement From the American Heart Association
Why the study?
Antithrombotic undertreatment due to omission, nonadherence, underdosing, and clinical factors leads to increased ischemic events and mortality, with gaps in care worsened by healthcare inequities.
Does undertreatment of antithrombotic therapy increase adverse outcomes in patients with atrial fibrillation, venous thromboembolism, or peripheral artery disease?
Design
Scientific statement review from the American Heart Association
Authors
Discussion
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Member takes
Implication
Antithrombotic undertreatment persists across common indications; leaves open how best to target adherence and access barriers in prospective studies.
Key Points
- Increased rates of ischemic stroke, systemic embolism, and recurrent thrombosis occur frequently when antithrombotic therapy is omitted or administered below therapeutic dosing levels.
- Scientific statement review of clinical practice indicates that patients with atrial fibrillation or venous thromboembolism frequently experience suboptimal anticoagulant dosing.
- Highlights structured antithrombotic stewardship as a transformative opportunity, urging multidisciplinary healthcare teams to actively correct treatment inequities and gaps in care.
Structured PICO
Does undertreatment of antithrombotic therapy increase adverse outcomes in patients with atrial fibrillation, venous thromboembolism, or peripheral artery disease?
P
Population
Patients with atrial fibrillation, venous thromboembolism, or peripheral artery disease
E
Exposure
Antithrombotic therapy (focusing on undertreatment, omission, nonadherence, or underdosing)
O
Outcome
Ischemic stroke, systemic embolism, recurrent thrombosis, and mortalityhard clinical
Undertreatment of antithrombotic therapy leads to increased rates of ischemic stroke, systemic embolism, recurrent thrombosis, and mortality, emphasizing the need for antithrombotic stewardship.
Cite This Study
Rudd et al. (2026) conducted a review in atrial fibrillation, venous thromboembolism, or peripheral artery disease. Antithrombotic therapy undertreatment was evaluated. Antithrombotic undertreatment increases rates of ischemic stroke, systemic embolism, recurrent thrombosis, and mortality.