Objective
Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with increased risk of stroke. Stroke risk in AF increases with comorbid diseases such as hypertension, coronary heart disease, congestive heart failure and vascular disease. Clinical risk scores, CHADS2 and CHA2DS2VASc were developed in order to estimate the risk of stroke in patients with non-valvular AF (NVAF). In this study we aimed to investigate oral anticoagulant (OAC) use in patients with NVAF and high risk of stroke.
Methods
ReAl-life Multicenter Survey Evaluating Stroke prevention strategies (RAMSES study) was a prospective, observational study that was conducted in outpatient cardiology clinics. Patients were excluded if they had valve replacement or mitral stenosis. A total number of 6273 NVAF patients were enrolled in RAMSES study and 5071 high risk of stroke patients (CHA2DS2VASc≥2) were included to the current analysis.
Methods
ReAl-life Multicenter Survey Evaluating Stroke prevention strategies (RAMSES study) was a prospective, observational study that was conducted in outpatient cardiology clinics. Patients were excluded if they had valve replacement or mitral stenosis. A total number of 6273 NVAF patients were enrolled in RAMSES study and 5071 high risk of stroke patients (CHA2DS2VASc≥2) were included to the current analysis.
Results
Of the 5071 patients 3649 (72%) were on OAC therapy. Male patients with high risk of stroke were treated with OAC less frequently than female patients (46.3% vs. 51.1%, p=0.002). Lower socioeconomic status and educational levels were also associated with less frequent OAC treatment (Table). Patients with comorbid diseases were less likely treated with OACs except for hypertension. Major bleeding rates were higher in non-OAC group while minor bleeding rates were higher in OAC group. Antiplatelet therapy was more frequently administered in patients with no OAC. When evaluated with CHA2DS2VASc (but not CHADS2) patients who were not on OAC therapy had a significantly higher risk of stroke comparing OAC group (p<0.001).
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