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One in four low-risk atrial fibrillation patients ‘inappropriately anticoagulated’



More than a quarter of patients with atrial fibrillation who are at low risk of stroke are being ‘inappropriately’ prescribed an oral anticoagulant, a recent audit of UK general practices has claimed.

Researchers ran the computerised GRASP-AF (Guidance on Risk Assessment and Stroke Prevention in Atrial Fibrillation) audit tool on electronic records of 11 general practices.

Of the 7.5% of patients with atrial fibrillation who were considered at low risk of stroke, according to the CHA2DS2-VASc score now endorsed by NICE guidelines for atrial fibrillation, 28%were on oral anticoagulants.

Just half of patients at moderate-high risk of stroke were on the recommended treatment of an oral anticoagulant, while about 40% were on an antiplatelet – which is no longer recommended for stroke prevention.

The researchers concluded: ‘Oral anticoagulant therapy in atrial fibrillation remains suboptimal in the UK general practice settings, with suboptimal treatment of high-risk patients and inappropriate oral anticoagulant use in low-risk patients.

‘Aspirin monotherapy use remained excessive in high-risk patients, despite exposing such patients to an increased risk of stroke.’

The findings were presented at a poster session at the annual European Society of Cardiology congress in Barcelona.

European Society of Cardiology Congress 2014; Abstract P2630

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