Many patients with atrial fibrillation are not on optimal therapy, according to a recent study that found one-third of patients are not prescribed the gold standard for blood thinners.
Published in the Journal of the American College of Cardiology, this study looked at blood thinner use among patients with atrial fibrillation. Atrial fibrillation (or AFib) is the most common type of irregular heart rhythm, affecting up to 6 million people in the United States.
Since atrial fibrillation increases risk of stroke, blood thinners are recommended to prevent clots and reduce risk for heart events. Current guidelines recommend prescription blood thinners like warfarin for AFib patients at moderate to high risk of stroke, rather than aspirin alone. But how well are we meeting guidelines in the real world?
To learn more, researchers analyzed data from the American College of Cardiology’s PINNACLE Registry, which tracks heart patients to improve care and treatment. More than 505,000 AFib patients were included in the analysis, all of whom enrolled in the registry between 2008 and 2012 and took some form of blood thinner as part of therapy. Patients also had moderate to high risk for stroke based on risk factors like age and blood pressure.
Based on current guidelines, prescription blood thinners should have been recommended for all patients included in this study, rather than aspirin alone. However, only 60–62% of patients were treated with warfarin or non-vitamin K antagonist drugs, while the remaining 38–40% took aspirin only.
After analysis, researchers found that patients with high blood pressure, high cholesterol and heart disease were more likely to take aspirin only than those without. In contrast, patients taking prescription blood thinners were more likely to be male, overweight or obese and have a history of stroke or heart failure.
Based on findings, it’s clear that treatment recommendations are not being consistently applied to patients with atrial fibrillation. Among patients eligible for prescription blood thinners, one-third of patients do not receive optimal therapy. This gap in care is especially prominent among patients with AFib and heart disease, who are at particularly high risk for heart events.
To address this issue, experts highlight the need to increase appropriate prescription of prescription blood thinners in patients with atrial fibrillation. Authors also encourage future research to better understand the factors that drive sub-optimal therapy in AFib patients.