[Antithrombotic treatment in non-rheumatic atrial fibrillation. Do we follow the recommendations of clinical trials?].

OBJECTIVES

Several clinical trials have demonstrated that antithrombotic treatment may be effective in prevention of stroke in nonrheumatic atrial fibrillation (AF). The aim of this study was to assess if we follow clinical trial recommendations in community practice.

METHODS

We analyzed 225 medical records of patients diagnosed of nonrheumatic AF in Cáceres, during February and March 1998. Patients who were contraindicated to follow antiagreggation or anti-coagulation treatment were excluded. We compared patients with and without antithrombotic treatment with different demographic characteristics and embolic risk factors.

RESULTS

205 patients were included in the study, 149 (72.6%) had high embolic risk. 62 (30.2%) followed anticoagulation, 94 (45.8%) antiaggregation treatment, 5 (2.4%) both treatment and 49 (24%) were not receiving therapy. We didn't findings differences between age, sex, presence of ischemic heart disease, hypertension and congestive heart failure in last three months compared with the patients in respect to the group of patients with anticoagulation and antiaggregation therapy or without it. We determinate as well that previous stroke and echocardiographical finds (valve disease, valve calcification, ventricular dysfunction) were more frequent in the anticoagulation and antiaggregate patients than in those without therapy.

CONCLUSION

A high range of nonrheumatic AF patients take any kind of antithrombotic preventive therapy, though a great number of patients with high embolic risk could still get benefits from anticoagulation therapy. We should considerate in the therapy assessment some other clinical characteristics as hypertension, isquemic heart disease and heart failure apart from echocardiographical findings.