Guideline adherence in antithrombotic treatment after concomitant ablation surgery in atrial fibrillation patients

Interactive Cardiovascular and Thoracic Surgery
Henrica N A M van BreugelJos G Maessen

Abstract

We investigated real-life oral anticoagulation (OAC) treatment after surgical ablation and examined its adherence to current recommendations. We also explored factors related to OAC use preoperatively and at follow-up. One hundred and fifteen patients with atrial fibrillation (AF) were evaluated during 12-month follow-up after surgery. Patients were divided into two categories according to the congestive heart failure, hypertension, age ≥75 years, diabetes and prior stroke [or transient ischaemic attack or thromboembolism] (CHADS2) score: 60 patients were assigned to the high-risk group (CHADS2 score ≥2) and 55 to the low-risk group (CHADS2 score ≤1). OAC use was defined as guideline adherent, undertreatment or overtreatment. Baseline overall guideline adherence was 62%. OAC was underprescribed in high-risk patients and overprescribed in low-risk patients (both, P < 0.001). The only factor associated with OAC use after logistic regression analysis were age >75 years (P = 0.01) and preoperative AF > paroxysmal (P = 0.013). Overall guideline adherence at 12-month follow-up showed a trend towards a better adherence in the sinus rhythm (SR) subgroup (74% vs 55%, P = 0.02). OAC was underprescribed in high-risk patients and overpresc...Continue Reading

References

Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
May 30, 2006·European Heart Journal·Robby NieuwlaatUNKNOWN Euro Heart Survey Investigators
Feb 26, 2008·Journal of the American College of Cardiology·Margaret C FangUNKNOWN ATRIA Study Group
Apr 19, 2008·Stroke; a Journal of Cerebral Circulation·UNKNOWN Stroke Risk in Atrial Fibrillation Working Group
May 2, 2008·Thrombosis and Haemostasis·Robert D McBaneWaldemar E Wysokinski
Mar 12, 2009·Thrombosis and Haemostasis·Kok Hoon TayDeirdre A Lane
May 1, 2009·Thrombosis and Haemostasis·Deirdre A Lane, Gregory Y H Lip
Sep 5, 2009·Journal of the American College of Cardiology·Daniela PoliDomenico Prisco
Sep 30, 2009·Seminars in Thrombosis and Hemostasis·Ron PistersHarry J G M Crijns
Sep 30, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·A John CammUNKNOWN ESC Committee for Practice Guidelines
Jan 12, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sandro GelsominoJos Maessen
Nov 1, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sandro GelsominoMark La Meir

❮ Previous
Next ❯

Citations

Feb 14, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Chen TingtingLv Qianzhou

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.