Auricular fibrillation as a risk factor of cerebrovascular events in the over-65s. Is clinical practice in anticoagulant prophylaxis adequate?

To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF). Cross-sectional study. Ourense's area with 95,840 inhabitants over 65 years. Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than...

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Bibliographic Details
Published in:Atención primaria 2005-09, Vol.36 (4), p.198-203
Main Authors: Gayoso Diz, P, Calle Custodio, R, Prieto Maroto, A, Herrera Calvo, D, Sala López, A I, Gómez Mosquera, M D
Format: Article
Language:Spanish
Subjects:
Administration, Oral
Age Factors
Aged
Anticoagulants - administration & dosage
Anticoagulants - therapeutic use
Atrial Fibrillation - complications
Atrial Fibrillation - drug therapy
Confidence Intervals
Cross-Over Studies
Data Interpretation, Statistical
Drug Prescriptions
Humans
Hypertension - complications
Odds Ratio
Risk Factors
Stroke - prevention & control
Warfarin - administration & dosage
Warfarin - therapeutic use
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Summary:To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF). Cross-sectional study. Ourense's area with 95,840 inhabitants over 65 years. Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than 75 year. Demographic characteristics, personal history, stroke risk, diagnostic characteristics of AF, antithrombotic treatment, and its adequacy. Only 33% high risk patients received oral anticoagulation (OCA) with warfarin at diagnosis. Some features were found to be significant independent risk factors for OCA: age (older than 75 vs 65-74 years; odds ratio =0.32; 95% confidence interval, 0.18-0.59), and prior stroke (odds ratio =2.02; 95% confidence interval, 1.16-3.55). Warfarin prophylactic is insufficiently prescribed, especially in older than 75 years (with high baseline risk of stroke and no counter-indications). There was inadequate prescription in 73.4% cases.
ISSN:0212-6567