Tuesday, February 13, 2007
warfarin
Guidelines for Antithrombotic Therapy in Atrial Fibrillation Frequently Not Followed
Atrial fibrillation patients frequently do not receive antithrombotic therapy according to guidelines, a population-based study in Archives of Internal Medicine finds.
Researchers analyzed the medical records of some 570 patients, aged 30 to 84, with newly diagnosed atrial fibrillation (AF); three quarters of them met age and cardiovascular criteria for high stroke risk. Although guidelines call for warfarin anticoagulation for all high-risk AF patients, only 41% of such study participants received it. Indeed, AF classification, rather than stroke risk factors, was the strongest predictor of warfarin use. And even among participants who did receive warfarin, the target international normalized ratio (INR) range was maintained less than half the time.
Journal Watch Oncology and Hematology Associate Editor Dr. David Green offers one explanation for the underuse of warfarin: "Physicians often are reluctant to prescribe warfarin anticoagulation to frail elders because of concerns about bleeding; however, such bleeding is most likely to occur in patients whose INRs exceed the therapeutic range."
Archives of Internal Medicine article (Free abstract; full text requires subscription)
ACCP guidelines (Free)
ACC/AHA/ESC guidelines (Free)
Atrial fibrillation patients frequently do not receive antithrombotic therapy according to guidelines, a population-based study in Archives of Internal Medicine finds.
Researchers analyzed the medical records of some 570 patients, aged 30 to 84, with newly diagnosed atrial fibrillation (AF); three quarters of them met age and cardiovascular criteria for high stroke risk. Although guidelines call for warfarin anticoagulation for all high-risk AF patients, only 41% of such study participants received it. Indeed, AF classification, rather than stroke risk factors, was the strongest predictor of warfarin use. And even among participants who did receive warfarin, the target international normalized ratio (INR) range was maintained less than half the time.
Journal Watch Oncology and Hematology Associate Editor Dr. David Green offers one explanation for the underuse of warfarin: "Physicians often are reluctant to prescribe warfarin anticoagulation to frail elders because of concerns about bleeding; however, such bleeding is most likely to occur in patients whose INRs exceed the therapeutic range."
Archives of Internal Medicine article (Free abstract; full text requires subscription)
ACCP guidelines (Free)
ACC/AHA/ESC guidelines (Free)
# posted by roodbont @ 3:39 PM 
