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UK patients not receiving anticoagulants properly

While oral anticoagulation (OAC) is recommended for the majority of patients with atrial fibrillation (AF) and ≥1 risk factor for stroke, OACs are not being prescribed for UK patients as per guidelines. This was the finding from a retrospective analysis of 105,000 patients enrolled into an observational community-based registry of 11 general practices (GP) serving the town of Darlington, England.

Presented by Dr M Mazurek (University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham), antithrombotic treatment (ATT) uptake was assessed against the 2014 National Institute for Health and Care Excellence (NICE) guidelines (CHA2DS2-VASc ≥ 1 in men and ≥2 in women). The follow up period was 12 months.

Overall, 2,259 (2.15%) AF patients were identified in the retrospective analysis (mean age 75.6 years; 46.1% female), of whom only 50.8% received NICE guideline adherent stroke thrombo-prophylaxis. Multivariate analyses revealed that non-guideline adherent ATT was associated with a significant increase in the risk of stroke (odds ratio [OR] 2.38, p=0.023) and all-cause death (OR 1.58, 95% p=0.006 for under-treatment).

The authors concluded that only half of eligible AF patients were prescribed OAC therapy in line with guidelines, and they suggest that implementation of guideline adherent stroke prevention is essential for optimal management of AF patients.

Reference

1. Mazurek M. Guideline adherent antithrombotic treatment improves outcomes in patients with atrial fibrillation – insights from the community based Darlington atrial fibrillation registry. Abstract P6444. Eur Heart J 2016;37(Abstract supplement): 1348.

Published on: October 19, 2016

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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