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Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation

Nieuwlaat, Robby ; Capucci, Alessandro ; Lip, Gregory Y. H. ; Olsson, Bertil LU ; Prins, Martin H. ; Nieman, Fred H. ; Lopez-Sendon, Jose ; Vardas, Panos E. ; Aliot, Etienne and Santini, Massimo , et al. (2006) In European Heart Journal 27(24). p.3018-3026
Abstract
Aims To describe guideline adherence and application of different stroke risk strati. cation schemes regarding antithrombotic therapy in real-life atrial. brillation (AF) patients and to assess which factors influence antithrombotic management decisions. Methods and results The Euro Heart Survey enrolled 5333 AF patients in 35 countries, in 2003 and 2004. Prescription of antithrombotic drugs, especially oral anticoagulation (OAC), was hardly tailored to the patient's stroke risk pro. le as indicated by the joint guidelines of the American College of Cardiology, American Heart Association, and the European Society of Cardiology, ACCP guidelines, or CHADS(2) and Framingham risk scores. In multivariable analysis, only a limited number of the... (More)
Aims To describe guideline adherence and application of different stroke risk strati. cation schemes regarding antithrombotic therapy in real-life atrial. brillation (AF) patients and to assess which factors influence antithrombotic management decisions. Methods and results The Euro Heart Survey enrolled 5333 AF patients in 35 countries, in 2003 and 2004. Prescription of antithrombotic drugs, especially oral anticoagulation (OAC), was hardly tailored to the patient's stroke risk pro. le as indicated by the joint guidelines of the American College of Cardiology, American Heart Association, and the European Society of Cardiology, ACCP guidelines, or CHADS(2) and Framingham risk scores. In multivariable analysis, only a limited number of the well-known stroke risk factors triggered OAC prescription. In contrast, less relevant factors, of which clinical type of AF and availability of an OAC monitoring outpatient clinic were the most marked, played a significant role in OAC prescription. Electrical cardioversions and catheter ablations clearly triggered OAC prescription, whereas pharmacological cardioversions even in the presence of stroke risk factors did not. Conclusion Antithrombotic therapy in AF is hardly tailored to the patient's stroke risk pro. le. Factors other than well-known stroke risk factors were significantly involved in antithrombotic management decisions. To facilitate this tailored treatment, guideline writers and physician educators should focus on providing one uniform and easy to use stroke risk strati. cation scheme. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anticoagulation, oral, antithrombotic therapy, atrial fibrillation, stroke, guidelines, risk stratification
in
European Heart Journal
volume
27
issue
24
pages
3018 - 3026
publisher
Oxford University Press
external identifiers
  • wos:000242715900024
  • scopus:33845718250
ISSN
1522-9645
DOI
10.1093/eurheartj/ehl015
language
English
LU publication?
yes
id
7b86a300-30eb-44b3-96cb-01e852835954 (old id 683382)
date added to LUP
2016-04-01 15:37:47
date last changed
2020-12-08 03:19:37
@article{7b86a300-30eb-44b3-96cb-01e852835954,
  abstract     = {Aims To describe guideline adherence and application of different stroke risk strati. cation schemes regarding antithrombotic therapy in real-life atrial. brillation (AF) patients and to assess which factors influence antithrombotic management decisions. Methods and results The Euro Heart Survey enrolled 5333 AF patients in 35 countries, in 2003 and 2004. Prescription of antithrombotic drugs, especially oral anticoagulation (OAC), was hardly tailored to the patient's stroke risk pro. le as indicated by the joint guidelines of the American College of Cardiology, American Heart Association, and the European Society of Cardiology, ACCP guidelines, or CHADS(2) and Framingham risk scores. In multivariable analysis, only a limited number of the well-known stroke risk factors triggered OAC prescription. In contrast, less relevant factors, of which clinical type of AF and availability of an OAC monitoring outpatient clinic were the most marked, played a significant role in OAC prescription. Electrical cardioversions and catheter ablations clearly triggered OAC prescription, whereas pharmacological cardioversions even in the presence of stroke risk factors did not. Conclusion Antithrombotic therapy in AF is hardly tailored to the patient's stroke risk pro. le. Factors other than well-known stroke risk factors were significantly involved in antithrombotic management decisions. To facilitate this tailored treatment, guideline writers and physician educators should focus on providing one uniform and easy to use stroke risk strati. cation scheme.},
  author       = {Nieuwlaat, Robby and Capucci, Alessandro and Lip, Gregory Y. H. and Olsson, Bertil and Prins, Martin H. and Nieman, Fred H. and Lopez-Sendon, Jose and Vardas, Panos E. and Aliot, Etienne and Santini, Massimo and Crijns, Harry J. G. M.},
  issn         = {1522-9645},
  language     = {eng},
  number       = {24},
  pages        = {3018--3026},
  publisher    = {Oxford University Press},
  series       = {European Heart Journal},
  title        = {Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehl015},
  doi          = {10.1093/eurheartj/ehl015},
  volume       = {27},
  year         = {2006},
}