LONDON (Reuters Health) – Contrary to recommended guidelines, many Swedish physicians fail to prescribe warfarin to patients with chronic atrial fibrillation (AF), researchers report.
Dr. Viveka Frykman from the Karolinska Hospital in Stockholm and colleagues sent questionnaires to 728 physicians asking about compliance with practice guidelines. The researchers also reviewed the medical records of 200 consecutive patients who had been hospitalized for AF, according to their report in the October issue of the European Heart Journal.
Of the 493 physicians who responded to the questionnaire, over 94% said that patients who were at risk for thrombolytic complications and chronic AF should be on long-term warfarin therapy.
One hundred sixty-seven patients had no contraindications for anticoagulation therapy. Of these, 108 patients were in chronic AF. Among the patients with no contraindications for anticoagulation therapy, the investigators found that only 40% were on warfarin and 42% were on aspirin.
"The most serious finding was a significant under-use of anticoagulation treatment, even in patients at a high risk of thromboembolic stroke," the Swedish researchers write.
"The European Society of Cardiology has recently announced their strategy of studying clinical practice patterns by careful monitoring of various cardiac conditions in their Euro Heart Survey programme. This is an important and highly welcome initiative in which management of atrial fibrillation ought to be included," Dr. Frykman and colleagues conclude.
Eur Heart J 2001;22:1954-1959.
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