In nonvalvular atrial fibrillation stroke prevention by anticoagulation is clearly recommended by evidence based medicine. Underusage of coumarin treatment however is a general problem. The aim of this study was the analysis of prehospital and hospital practice of anticoagulant therapy in a Hungarian cohort. 106 consecutive patients hospitalized in a Budapest medical department with chronic non-valvular atrial fibrillation were included. Mean age was 76 years, the percentage of males was 30%. High stroke risk factors were found in all patients, at least two of them in 72%. 70% of patients were 75 years old or more. Thus anticoagulant treatment was indicated in all patients, however at admission only 30% were anticoagulated, moreover therapeutic range was achieved in only 28% of them. At discharge in 77% of all patients and in 82% without contraindications coumarin treatment could be started, practically independently of age.
Conclusions: In the Hungarian prehospital practice anticoagulant treatment of nonvalvular atrial fibrillation is underused and inefficient, but excellent rates even in international comparison can be achieved by adequate medical approach even in the elderly.