Using Anticoagulants for Atrial Fibrillation Increases Long-term Use

Patients directed to use anticoagulants after an analysis of atrial fibrillation in the emergency department mostly continue long-term use of medications to treat the condition.

"In this multicentre study in Ontario, Canada, providing an oral anticoagulant prescription in the emergency department to patients with atrial fibrillation who were older than 65 years was associated with a marked increase in long-term use of this therapy," writes Dr. Clare Atzema, a senior scientist with ICES and the Division of Emergency Medicine, University of Toronto, with coauthors.

‘Physicians working in the emergency department should consider initiating oral anticoagulants in similar patients [patients with atrial fibrillation] who are being discharged home.’

More than 33 million people around the world have atrial fibrillation, that is, an irregular heartbeat that is associated with a fivefold increased risk of stroke as well as other cardiac issues. The use of oral anticoagulants can decrease stroke risk by 60%.

The usual practice is to refer to patients seen in the emergency department for atrial fibrillation to primary care or a cardiologist for anticoagulant prescription and follow-up.

In this study performed at 15 centers in Ontario, researchers found that if an oral anticoagulant was prescribed in the emergency department to patients aged 65 years or older who were not at high risk of bleeding, there was a 31% absolute increase in the tendency to fill the prescription at 6 months, compared with referral to the patient's physician to consider starting the medication.

"Physicians working in the emergency department should consider initiating oral anticoagulants in similar patients [patients with atrial fibrillation] who are being discharged home, because this action is associated with improved use of stroke prevention long after the patient leaves the emergency department," the authors recommend.

Source: Eurekalert