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Guidelines recommend the use of antithrombotic therapy for stroke prevention in patients with atrial fibrillation (AF), but compliance with these guidelines has not been widely studied among patients with newly detected AF.A population- based study of newly detected AF was conducted within a large health plan in Seattle,Wash.
Patients were stratified by embolic risk according to American College of Chest Physicians criteria. Seventy-three percent of patients with newly detected AF had some type of antithrombotic therapy prescribed after AF onset. Warfarin was used in only 59% of patients at highest risk for stroke. Aspirin was used in 28% of patients, and 24% of patients received neither aspirin nor warfarin. The major predictor of warfarin use was the presence of intermittent or sustained AF, not the magnitude of stroke risk. The authors concluded that these results were concerning, given the overwhelming evidence that warfarin use significantly reduces stroke risk in patients with AF.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.