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Aspirin the wrong easy option for AF management

Atrial fibrillation (AF) is set to double by 2050,1 according to a group of independent UK experts who reported recently.2 The report also states that, despite readily available checks, roughly half of AF patients still remain undetected.

The report also warns that UK GPs are taking the easy option of prescribing aspirin for stroke prevention in patients with AF, including those eligible for anticoagulation, despite clinical evidence demonstrating that anticoagulant therapies are far superior.3

30% of patients with AF who are eligible for treatment with an anticoagulant are prescribed aspirin (or other anti-platelets) or given no treatment at all, the authors find.  If things do not improve by 2050 there will be an estimated 720,000 patients with AF at risk of stroke being sub-optimally treated and many undiagnosed, they continue.

Speaking to BJC Arrhythmia Watch, co-author Dr Mark Davis said: “The sAFe report has been developed to highlight issues in the management of patients with atrial fibrillation (AF). AF is a complex issue and with prevalence increasing it’s vital that it is managed optimally. NICE estimates that between 70 and 80% of patients with AF are eligible for treatment with an anticoagulant, yet this is not reflected in real-life clinical practice”.

Dr Mark Davis

Dr Mark Davis

“Recent GRASP-AF data suggests that nationally there are many thousands of patients with a history of AF and known risk factors at high risk of stroke, who are currently not treated with an oral anticoagulant. Aspirin is routinely used in the management of AF. Latest NICE guidelines from 2006 recommend the use of aspirin for a small niche of patients, however, these require prompt revision and it is imperative that a patient’s CHADs score is measured accurately so that those at higher risk receive effective anticoagulation therapy,” Dr Davis concluded.

References

1. Camm, J et al. Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010;31:2369–429.

2. Stroke in Atrial Fibrillation Expert report. Authored by: Prof. Martin Cowie, Prof. John Camm, Dr. Alan Begg, Dr. Paul Kalra, Dr. Ian Menown, Dr. Mark Davis, the Stroke Association, Atrial Fibrillation Association and Anticoagulation Europe. Commissioned and funded by Boehringer Ingelheim (UK) Limited

3. Weber et al., Prevention of cardioembolic stroke in patients with atrial fibrillation, Expert Rev. Cardiovasc. Ther. 8(10), 1405–15 (2010)

Published on: July 24, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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