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Misuse of antithrombotic therapy in atrial fibrillation patients: frequent, pervasive and persistent

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Abstract

Purpose

To assess the use of antithrombotic therapy among atrial fibrillation (AF) patients in a Brazilian University Heart Hospital (InCor).

Methods and results

In a cross-sectional study we analyzed the charts of all patients treated at InCor in five separate days of 2002 (Phase 1). To assess the impact of admission to a cardiology hospital, a follow-up of the AF patients selected in Phase 1 was carried out after 1 year (Phase 2). The prevalence of AF in the 3,764 assessed charts was 8.0% (301 patients). In Phase 1, antiplatelets were prescribed to 21.2% and anticoagulant therapy (ACT) to 46.5% of AF patients; in Phase 2, to 19.9 and 57.8%, respectively. Thus, 32.2% (Phase 1) and 22.2% (Phase 2) of AF patients were not receiving any antithrombotic drug. Among AF patients with previous ischemic stroke (17.6%), only 49% (Phase 1) and 60.4% (Phase 2) were receiving ACT. As many as 34 and 22.6%, respectively, were not receiving any antithrombotic drug. After follow-up, a new acute embolic event was documented in 5.6% of patients, 17% died.

Conclusions

Anticoagulation is underused in AF patients and neither the fact of being treated by cardiologists in a University Hospital, nor the learning time-window of 1 year seemed to improve the antithrombotic care significantly.

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Authors and Affiliations

  1. Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil

    Luciana S. Fornari, Daniela Calderaro, Ivana B. Nassar, Cristiane Lauretti, Lidia Nakamura, Renato Bagnatori & Bruno Caramelli

  2. Department of Clinical and Biological Sciences, University of Insubria, Varese, Italy

    Walter Ageno

  3. Rua Barão do Teffé, 606, Jundiaí, SP, CEP 13208761, Brazil

    Luciana S. Fornari

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  1. Luciana S. Fornari
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  2. Daniela Calderaro
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Correspondence to Luciana S. Fornari.

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Fornari, L.S., Calderaro, D., Nassar, I.B. et al. Misuse of antithrombotic therapy in atrial fibrillation patients: frequent, pervasive and persistent. J Thromb Thrombolysis 23, 65–71 (2007). https://doi.org/10.1007/s11239-006-9012-9

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  • DOI: https://doi.org/10.1007/s11239-006-9012-9

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