Underuse of Oral Anticoagulation in Primary Prevention of Cardioembolic Stroke - Results of a Descriptive Prevalence Study

作者：Kral M^*; Herzig R; Sanak D; Skoloudik D; Bartkova A; Veverka T; Obereigneru R; Kovacik M; Zapletalova J

来源：Ceska a Slovenska Neurologie a Neurochirurgie, 2014, 77(1): 59-63.

• anticoagulation
• antiplatelet therapy
• atrial fibrillation
• cardioembolic stroke
• stroke prevention

Background: Oral anticoagulation therapy (OAT) is an effective treatment used in the prevention of cardioembolic stroke (CS). The aim was to assess the incidence of CS, especially caused by atrial fibrillation (AF), to analyse the OAT administration in patients with AF and acute ischemic stroke (AIS), and to investigate trends in AOT administration over a 5-year period. Methods: In a hospital-based, descriptive prevalence study, data on all first-time AIS patients admitted in 2007, 2008 and 2012 were analyzed. In CS patients, the incidence of AF (both in the medical history and recently), its treatment and the presence of contraindications to OAT administration in the case of previously known AF were recorded. Results: The incidence of CS and AF among the 2007 (n = 293), 2008 (n = 299) and 2012 (n = 307) patients was as follows: 34.1, 39.1 and 37.1% had CS; 75.0, 76.9 and 95.0% of CS patients had AF; 46.0, 53.8 and 61.0% of CS patients were diagnosed with AF prior to AIS. OAT was not used in 80.4, 79.4 and 77.0% of patients with AF known prior to AIS (although its administration was contraindicated in only 45.9, 50.0 and 38.3% of these patients, respectiverly) (p > 0.05 in all cases). Conclusions: The results of the present study demonstrated major undertreatment with OAT in the prevention of CS in patients with previously known AF with no trend towards improvement during the last five years.

• 出版日期2014