Anticoagulation prescription in atrial fibrillation

Expert Opin Pharmacother. 2011 Jul;12(10):1473-9. doi: 10.1517/14656566.2011.584063. Epub 2011 Jun 2.

Abstract

Aims: We seek to assess the factors associated with the anticoagulation prescription in a cohort of patients with atrial fibrillation (AF) collected from out-patient clinics.

Methods: A total of 1524 patients with a history of AF were collected from out-patients clinics. CHADS(2), CHA(2)DS(2)-VASc and HAS-BLED scores were calculated in every patient. Variables associated with anticoagulant treatment prescription were analyzed in univariant and multivariant models.

Results: Most patients received either anticoagulant (62%) or antiplatelet treatment (37%). Anticoagulation rates increased among higher CHADS(2) and CHA(2)DS(2)-VASc score values. A logistic regression model was performed to assess the variables associated with the prescription of anticoagulant treatment; the variables with stronger association were the presence of arrhythmia at the current visit (odds ratio (OR) 33, 95% CI 27-40, p<0.001) and lack of concomitant antiplatelet treatment (OR 0.17, 95% CI 0.14-0.21, p<0.001).

Conclusions: Although prognosis of patients with AF is mainly determined by the long-term thrombotic risk, the prescription of antithrombotic therapy depends more on the bleeding risk and the immediate thrombotic risk perception.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care Facilities
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Female
  • Hemorrhage / chemically induced
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Risk Factors
  • Thrombosis / etiology
  • Thrombosis / prevention & control*

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors