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Pharmacotherapy. 2000 Sep;20(9):1060-5.

Adequacy of anticoagulation in patients with atrial fibrillation coming to a hospital.

Author information

1
Division of Cardiology, University of Alberta, Edmonton, Canada.

Abstract

STUDY OBJECTIVE:

To evaluate the adequacy of anticoagulation in patients with atrial fibrillation (AF) coming to a hospital.

DESIGN:

Retrospective medical record review.

SETTING:

Tertiary care hospital.

PATIENTS:

Consecutive patients with a history of AF who had been prescribed warfarin and who had the international normalized ratio (INR) measured when they arrived at the hospital. Those who developed AF as a complication during hospitalization were excluded.

MEASUREMENTS AND MAIN RESULTS:

Of 1085 patients, 375 (mean age 73 yrs, 56.3% men) were eligible for further evaluation. Most had nonvalvular AF; in 44.5% the INR was subtherapeutic, in 36.5% it was therapeutic, and in 18.9% it was supratherapeutic. Patients admitted for any thromboembolic event and for ischemic stroke were significantly more likely to have subtherapeutic INRs.

CONCLUSION:

It is well documented in the literature that warfarin is underprescribed, but our results suggest that even in treated patients, about half are inadequately protected from thromboembolism.

PMID:
10999498
DOI:
10.1592/phco.20.13.1060.35038
[Indexed for MEDLINE]

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