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