TY - JOUR
T1 - Warfarin and Aspirin Use in Atrial Fibrillation Among Practicing Cardiologist (from the AFFECTS Registry)
AU - Kowey, Peter R.
AU - Reiffel, James A.
AU - Myerburg, Robert
AU - Naccarelli, Gerald V.
AU - Packer, Douglas L.
AU - Pratt, Craig M.
AU - Reiter, Michael J.
AU - Waldo, Albert L.
N1 - Funding Information:
This study was supported by Reliant Pharmaceuticals, acquired by GlaxoSmithKline, Research Triangle Park, North Carolina , and was sponsored by Columbia University, New York, New York .
PY - 2010/4/15
Y1 - 2010/4/15
N2 - Among patients with atrial fibrillation (AF), the risk of thromboembolism is a significant concern. However, the reported use of warfarin among patients with AF at elevated risk of stroke remains low. In the present study, we have provided information on anticoagulation use reported during the recent Atrial Fibrillation: Focus on Effective Clinical Treatment Strategies (AFFECTS) Registry. Among patients identified by their physician at baseline to be at an increased risk of stroke, as determined from an assessment of the medical history, 74% received warfarin and 29% received aspirin. Post hoc analysis of warfarin use stratified by Congestive heart failure, Hypertension, Age, Diabetes, Stroke, (CHADS2) doubled score revealed that at the end of the study, warfarin use was 73% (155 of 213) and 66% (185 of 280) in the rate- and rhythm-control patients with a score of ≥2, respectively, compared to 60% (183 of 306) and 49% (322 of 662) in the rate- and rhythm-control patients with a score of <2, respectively. The practicing cardiologists who participated in this registry initiated anticoagulation therapy in most of their patients with AF. However, warfarin use is not yet in line with the guidelines and evidence-based recommendations. Patients considered at no risk of stroke appear to have been overprescribed anticoagulant agents, and a considerable portion of high-risk patients did not receive warfarin. In conclusion, these results suggest that continued physician education of appropriate anticoagulation use in patients with AF is needed.
AB - Among patients with atrial fibrillation (AF), the risk of thromboembolism is a significant concern. However, the reported use of warfarin among patients with AF at elevated risk of stroke remains low. In the present study, we have provided information on anticoagulation use reported during the recent Atrial Fibrillation: Focus on Effective Clinical Treatment Strategies (AFFECTS) Registry. Among patients identified by their physician at baseline to be at an increased risk of stroke, as determined from an assessment of the medical history, 74% received warfarin and 29% received aspirin. Post hoc analysis of warfarin use stratified by Congestive heart failure, Hypertension, Age, Diabetes, Stroke, (CHADS2) doubled score revealed that at the end of the study, warfarin use was 73% (155 of 213) and 66% (185 of 280) in the rate- and rhythm-control patients with a score of ≥2, respectively, compared to 60% (183 of 306) and 49% (322 of 662) in the rate- and rhythm-control patients with a score of <2, respectively. The practicing cardiologists who participated in this registry initiated anticoagulation therapy in most of their patients with AF. However, warfarin use is not yet in line with the guidelines and evidence-based recommendations. Patients considered at no risk of stroke appear to have been overprescribed anticoagulant agents, and a considerable portion of high-risk patients did not receive warfarin. In conclusion, these results suggest that continued physician education of appropriate anticoagulation use in patients with AF is needed.
UR - http://www.scopus.com/inward/record.url?scp=77950457719&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77950457719&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2009.11.047
DO - 10.1016/j.amjcard.2009.11.047
M3 - Article
C2 - 20381665
AN - SCOPUS:77950457719
SN - 0002-9149
VL - 105
SP - 1130
EP - 1134
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -