Differential use of warfarin for secondary stroke prevention in patients with various types of atrial fibrillation.

The American Journal of Cardiology
William R LewisLee H Schwamm

Abstract

Anticoagulation therapy significantly reduces the incidence of thromboembolic events in patients with atrial fibrillation (AF), and warfarin therapy at discharge is a class I-indicated drug in patients with ischemic stroke with persistent or paroxysmal AF without contraindications. The aim was to determine whether participation in the Get With The Guidelines-Stroke (GWTG-S) quality improvement program would be associated with improved adherence to anticoagulation guidelines for patients with all types of AF. Adherence to warfarin treatment at hospital discharge was assessed in eligible patients with AF who presented with stroke or transient ischemic attack, based on type of AF. Of patients with stroke, 10.5% presented with some form of AF. When AF was documented using electrocardiography or telemetry (ECG) during the present admission, eligible patients were more likely to receive warfarin compared with patients for whom AF was reported using medical history only (78.8% vs 49.4%; p<0.0001). Improvement after GWTG-S participation in warfarin use was observed in patients with ECG-documented AF (73.8% at baseline vs 88.5% after the intervention; p<0.0001), but not patients using history only. Women and elderly patients were less l...Continue Reading

References

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Citations

Jul 31, 2013·Current Atherosclerosis Reports·Gisele Sampaio Silva, Lee H Schwamm
May 27, 2011·Thrombosis and Haemostasis·Isla M OgilvieGregory Y H Lip
May 17, 2011·The American Journal of Geriatric Pharmacotherapy·Ahmed Alhusban, Susan C Fagan
Apr 20, 2010·The American Journal of Medicine·Peter J ZimetbaumMatthew Emons
Oct 21, 2009·The American Journal of Cardiology·Jeremiah P DeptaUNKNOWN Get With The Guidelines Steering Committee and Investigators
Oct 18, 2016·The American Journal of Medicine·Michał MazurekGregory Y H Lip
Feb 6, 2017·Continuum : Lifelong Learning in Neurology·Andrew M Southerland
Jun 8, 2013·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Hasan KayaMehmet Siddik Ulgen
Oct 8, 2017·Qualitative Health Research·Stuart W GrandeMegan Coylewright
Sep 4, 2014·Circulation. Cardiovascular Quality and Outcomes·William R LewisGregg C Fonarow
Mar 29, 2012·Stroke; a Journal of Cerebral Circulation·Michael KatsnelsonMauro Moscucci

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