Underutilization of anticoagulation therapy in chronic atrial fibrillation

Japanese Heart Journal
G B GuoC H Yang

Abstract

Atrial fibrillation, the most common chronic arrhythmia, results in an increased risk of stroke. Anticoagulation therapy can reduce this risk, but appears to be underused. The objective of this study was to examine the use of warfarin and prevalence of stroke in patients with rheumatic, nonrheumatic valvular and nonvalvular atrial fibrillation. Between January 1993 and December 1998, 457 chronic atrial fibrillation patients with continuous follow-up in our hospital were identified as having rheumatic heart disease (n = 114): nonrheumatic valvular disease (n = 65); or nonvalvular disease (n = 278). Warfarin was used less often in patients with nonrheumatic valvular (16.7%) and nonvalvular diseases (20.1%) than in those with rheumatic heart disease (81.6%, p < 0.001). In contrast, the prevalence of stroke among patients with nonvalvular disease was 40.3% which was similar to the 33.3% found in patients with rheumatic heart disease but significantly higher than the 24.6% found in patients with nonrheumatic valvular disease (p < 0.05). A history of stroke did not alter the trend of use of warfarin among the three groups of patients. Only 20.6% of patients on warfarin received monthly monitoring of prothrombin time. In conclusion, t...Continue Reading

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Citations

Jul 12, 2005·Cerebrovascular Diseases·Chun-ming CheungChen-ya Huang
Jun 15, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Satoshi OgawaKazuhiro Kanmuri
Oct 8, 2009·International Heart Journal·Borut JugIrena Keber
May 13, 2014·European Journal of Clinical Pharmacology·Durga BistaGregory Peterson
Aug 30, 2008·Pharmacotherapy·Nita A Limdi, David L Veenstra
Feb 22, 2014·Archives of Cardiovascular Diseases·Habib GamraUNKNOWN RealiseAF investigators
May 23, 2016·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·Xue LiEsther W Chan
Jul 10, 2016·International Journal of Cardiology·Eun Joo ChoiNam Kyung Je
Nov 23, 2011·International Journal of Stroke : Official Journal of the International Stroke Society·Hsiu-Chin YuChi-Hsiao Yeh

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