We have located links that may give you full text access.
14 Are patients with stroke and atrial fibrillation receiving appropriate anticoagulation?
Heart 2014 June
AIM: To improve an appropriate use of antithrombotic therapy in atrial fibrillation (AF) on the basis of the presence (or absence) of stroke risk factors (based on CHA2DS2VASc score) as per ESC guideline.
METHOD: This was a retrospective audit and data was obtained from the health record department on the total number of stroke admissions in 2012. A proforma based on the ECS guide was created and used to collect data from those that were coded as having a diagnosis of AF alongside the CVA.
RESULTS: There were a total of 389 admissions with stroke in 2012 and 108 of these had a diagnosis of AF.29.9% of which were a new diagnosis AF at the time of admission. Of those who were known to have AF only 30.9% were anti-coagulated with Warfarin (W) despite all having a CHADS VASC score of 1 or more.46.8% of those had no documentation on the reason for the omission of anticoagulants.3 patients had a stroke while awaiting the initiation of W. heartjnl;100/Suppl_3/A7-a/F1F1F1 Abstract 14 Figure 1 For those on W, 46.2% of those with an ischaemic stroke had a sub-therapeutic INR at the time of admission. The time in therapeutic range for the patients on W was calculated using the Rosendaal method. This demonstrated that 64.7%of all the patients on W had a TTR below 60%. heartjnl;100/Suppl_3/A7-a/F2F2F2 Abstract 14 Figure 2 There were no patients on Novel Oral Anticoagulants (NOAC) in our audit.
CONCLUSION: The majority of patients with known AF were not on W despite > 95 % having a CHADS VASC score greater than 1. Those who were on W had poor INR control. 3 patients had a stroke while waiting for initiation of W. We believe that the risks of AF still needs to be highlighted and the use of NOACS in this cohort would have reduced stroke rate considerably.
METHOD: This was a retrospective audit and data was obtained from the health record department on the total number of stroke admissions in 2012. A proforma based on the ECS guide was created and used to collect data from those that were coded as having a diagnosis of AF alongside the CVA.
RESULTS: There were a total of 389 admissions with stroke in 2012 and 108 of these had a diagnosis of AF.29.9% of which were a new diagnosis AF at the time of admission. Of those who were known to have AF only 30.9% were anti-coagulated with Warfarin (W) despite all having a CHADS VASC score of 1 or more.46.8% of those had no documentation on the reason for the omission of anticoagulants.3 patients had a stroke while awaiting the initiation of W. heartjnl;100/Suppl_3/A7-a/F1F1F1 Abstract 14 Figure 1 For those on W, 46.2% of those with an ischaemic stroke had a sub-therapeutic INR at the time of admission. The time in therapeutic range for the patients on W was calculated using the Rosendaal method. This demonstrated that 64.7%of all the patients on W had a TTR below 60%. heartjnl;100/Suppl_3/A7-a/F2F2F2 Abstract 14 Figure 2 There were no patients on Novel Oral Anticoagulants (NOAC) in our audit.
CONCLUSION: The majority of patients with known AF were not on W despite > 95 % having a CHADS VASC score greater than 1. Those who were on W had poor INR control. 3 patients had a stroke while waiting for initiation of W. We believe that the risks of AF still needs to be highlighted and the use of NOACS in this cohort would have reduced stroke rate considerably.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app