Inadequate oral anticoagulation with warfarin in women with cerebrovascular event and history of atrial fibrillation: the FibStroke study



: Bah Aissa, Nuotio Ilpo, Palomäki Antti, Mustonen Pirjo, Kiviniemi Tuomas, Ylitalo Antti, Hartikainen Päivi, Airaksinen KE Juhani, Hartikainen Juha EK

Publisher: TAYLOR & FRANCIS LTD

: 2021

: Annals of Medicine

: ANNALS OF MEDICINE

: ANN MED

: 53

: 1

: 287

: 294

: 8

: 0785-3890

: 1365-2060

DOI: https://doi.org/10.1080/07853890.2021.1875499

: https://research.utu.fi/converis/portal/detail/Publication/53302074


Background: Women with atrial fibrillation (AF) may be treated less actively with oral anticoagulation (OAC) than men.Patients and methods: We assessed sex differences in the implementation of stroke risk stratification with CHADS(2) and CHA(2)DS(2)-VASc scores and reasons not to use OAC in 1747 AF patients suffering their first cerebrovascular event after the AF diagnosis.Results: Women were older and had more often a high stroke risk (CHADS(2)/CHA(2)DS(2)-VASc >= 2) than men (p < .001). On admission, 46.4% of women and 48.2% of men were on OAC with no sex difference (p = .437). However, of patients without OAC, 74.4% of women and 49.5% of men should have been on OAC based on CHADS(2)/CHA(2)DS(2)-VASc >= 2 (p < .001). Conversely, 34.8% of men and 17.5% of women on OAC had a low or moderate risk (CHADS(2)/CHA(2)DS(2)-VASc 0-1, p < .001). A valid reason to omit OAC was reported in 38.6% of patients and less often in women (p < .001).Conclusions: OAC was underused in high-risk AF patients, particularly women, but prescribed often in men with low or moderate stroke risk. Reasons for omitting OAC treatment were poorly reported, particularly for women.

Last updated on 2024-26-11 at 16:32