Are Atrial Fibrillation Patients Receiving Warfarin in Accordance with Stroke Risk

摘要: Abstract Background Clinical guidelines for the management of atrial fibrillation and flutter provide recommendations anticoagulation based on patients' overall risk stroke. To determine real-world compliance physicians with these recommendations, we conducted a retrospective cohort study examining utilization warfarin in fibrillation/flutter patients by stroke level. Methods Patients qualifying diagnosis during ≥18 months' continuous enrollment between January 2003 September 2007, ≥6 eligibility after first diagnosis, were identified from US MarketScan database (Thomson Reuters, New York, NY). Warfarin use within 30 days was assessed according to risk, estimated using Congestive heart failure, Hypertension, Age >75 years, Diabetes, Stroke (CHADS 2 ) score. Results Of 171,393 included analysis, 20.0% had CHADS score 0 (low risk), 61.6% 1-2 (moderate 18.4% 3-6 (high risk). Warfarin, recommended high stroke-risk patients, given only 42.1% those 3-6. A similar percentage moderate (43.5%) or low (40.1%) received warfarin. Only 29.6% high-risk, 33.3% moderate-risk, 34.1% low-risk who started uninterrupted therapy 6 months following their initial prescription. Conclusions These data suggest that guideline should be provided accordance are not routinely followed clinical practice. The causes implications under-utilization warrant further study.