ANTICOAGULANT USE SUBOPTIMAL

Guidelines recommend the use ofantithrombotic therapy for stroke preventionin patients with atrial fibrillation(AF), but compliance with these guidelineshas not been widely studied amongpatients with newly detected AF.A population-based study of newly detected AFwas conducted within a large health planin Seattle,Wash.

Patients were stratified by embolicrisk according to American College ofChest Physicians criteria. Seventy-threepercent of patients with newly detectedAF had some type of antithrombotictherapy prescribed after AF onset.Warfarin was used in only 59% ofpatients at highest risk for stroke. Aspirinwas used in 28% of patients, and 24% ofpatients received neither aspirin norwarfarin. The major predictor of warfarinuse was the presence of intermittent orsustained AF, not the magnitude ofstroke risk. The authors concluded thatthese results were concerning, given theoverwhelming evidence that warfarinuse significantly reduces stroke risk inpatients with AF.

Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Carein High Point, NC.