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The use status of anticoagulation drugs for inpatients with nonvalvular atrial fibrillation in Southwest China

Authors Zheng HJ, Ouyang SK, Zhao Y, Lu K, Luo SX, Xiao H

Received 17 November 2016

Accepted for publication 28 December 2016

Published 3 March 2017 Volume 2017:10 Pages 69—77


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Huan Jie Zheng, Shu Kun Ouyang, Yue Zhao, Kai Lu, Su Xin Luo, Hua Xiao

Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

Background: Oral anticoagulants (OACs) are effective for the prophylaxis of stroke in patients with atrial fibrillation (AF). This cross-sectional study aimed to investigate the status of anticoagulation treatment for hospitalized AF patients in Southwest China.
Methods: A total of 4760 hospitalized patients with AF were enrolled from 21 hospitals in Chongqing city from January 1 to December 31, 2013.
Results: Among the enrolled patients, 3785 were diagnosed with nonvalvular AF. These patients had a mean age of 74.4±10.1 years. The mean CHADS2 score of all subjects was 2.60±1.34, and 80.7% of the patients had CHADS2 ≥2. The use rate of OACs was only 11.5% for patients with a high risk for stroke (CHADS2 ≥2) and was much lower in patients from the second-level hospitals than in patients from the third-level hospitals (5.8% vs. 16.9%, P<0.001). The leading reason for the underuse of OACs in high-risk patients was physician’s nonfeasance.
Conclusion: This study demonstrated that the underuse of anticoagulation therapy in hospitalized patients with nonvalvular AF was particularly serious in Southwest China, especially in the second-level hospitals. Urgent and effective measures are desperately needed to improve this alarming situation in China.

Keywords: atrial fibrillation, anticoagulation therapy, oral anticoagulant, antiplatelet therapy, international normalized ratio

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