Abstract
OBJECTIVE: To determine the factors associated with under utilization of anticoagulation in patients with atrial fibrillation (AF) with high risk profile for thromboembolism.METHODS: This descriptive cross-sectional study was conducted at Cardiovascular Department Lady Reading Hospital Peshawar, Pakistan and Cardiology Department Hayatabad Medical Complex Peshawar, Pakistan from 01-12-2014 to 28-02-2015. All patients visiting OPD of respective hospitals with electrocardiogram (ECG) evidence of AF and CHADS VASC score 2 or more and mitral stenosis and AF were included.RESULTS: Out of 205 patients, 114 (55.6%) were males and mean age was 60.7±4.7 years. Out of 205, 149 (72.7%) were candidates for an-ticoagulation. AF patients with CHA2DS2 VASc score of ≥2 were 130 while patients with mitral stenosis and AF were 19. Only 41(27.5%) patients were adequately treated with anticoagulant therapy using vitamin K antagonist (VKA) or novel oral anticoagulant drugs. Factors associated with underutilization of anticoagulant therapy were, patient preference 27.8%, older age of 65 and above 17.6%, use of dual anti-platelet therapy 28.7 %, monitoring issue 9.3%, affordability 8.3% and prior complications due to anticoagulation therapy in 8.3%.CONCLUSION: Patients refusal of taking anticoagulation therapy, poverty, older age, lack of monitoring facility, previous complications or use of anti-platelet therapy are major causes of under utilization of anticoagulant therapy in patients with AF.
Abdul Malik, Farooq Ahmad, Ikramullah, Israr Ahmad, Salman Ahmad. (2016) FACTORS ASSOCIATED WITH UNDER UTILIZATION OF ANTICOAGULATION IN PATIENTS WITH ATRIAL FIBRILLATION WITH HIGH RISK PROFILE FOR THROMBOEMBOLISM, KHYBER MEDICAL UNIVERSITY JOURNAL, Volume 8, Issue 3.
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