Anticoagulants remain under-used in patients with atrial fibrillation (A.fib) who experienced a stroke, according to a study in JAMA .
In a study of 94,474 patients admitted to hospital with acute ischemic stroke and known history of A.fib, almost 85 per cent were not receiving anticoagulation therapy prior to stroke and 30 per cent were not receiving antithrombotic treatment prior to stroke. Only 7.6 per cent were receiving warfarin, 8.8 percent were receiving novel oral anticoagulants (NOACs) and 40 per cent were receiving antiplatelet therapy only. Therapeutic anticoagulation was associated with lower odds of moderate or severe stroke and lower odds of in-hospital mortality.
A.fib increases the risk of stroke by a factor of 4 to 5, and accounts for 10-15 per cent of all ischaemic strokes. While the burden of A.fib-related stroke is high, the condition is a potentially treatable risk factor.
“Atrial fibrillation is a highly prevalent and important, but treatable, risk factor for stroke. Despite numerous international guideline recommendations, many patients fail to receive proper treatment for stroke prevention,” the study authors write.