Acta Pharm. 67 (2017) 227-236
Original research paper
Real-practice thromboprophylaxis
in atrial fibrillation
PAOLA DEAMBROSIS, ALESSANDRA BETTIOL, JENNY
BOLCATO, ROBERTA PIROLO, GIULIA FRANCHIN, SAKIS THEMISTOCLAKIS, MICHELE
PELLIZZARI, ALESSANDRO CHINELLATO and PIETRO GIUSTI
1 Department of Pharmaceutical and Pharmacological
Science, University of Padua, Largo Egidio Meneghetti 2, 35131, Padua, Italy
2 Local Health Authority n.9 of Treviso, Pharmaceutical
Service, Piazza Ospedale 1, 31100, Treviso, Italy
3 Local Health Authority n.12 of Venezia,
Hospital Unit of Electrophysiology and Electrostimulation
Dell’Angelo Hospital, Via Paccagnella 11, 30174, Mestre, Italy
4 Veneto Region, Regional
Epidemiological Centre, Passaggio Gaudenzio
1, 35131, Padova, Italy
Accepted January 15, 2017
Published online March 3,
2017
This retrospective observational study was based on databases of the Local Health Authority of Treviso, Italy. It evaluated the prevalence and the effectiveness of oral anticoagulation treatment (OAT) for the management of non-valvular atrial fibrillation (NVAF) in everyday clinical practice. Out of 6,138 NVAF patients, only 3,024 received vitamin K antagonists (VKA). Potential barriers decreasing the probability of being treated with VKA were female sex, older age, antiplatelet treatment and a history of bleeding. In addition, VKA-treatment was not in line with current ESC and AIAC guidelines, since the patients at high or low risk of stroke were under- or over-treated, resp. Among VKA-treated patients, 73 % of subjects were not targeted for anticoagulation. OAT showed to be effective in reducing stroke risk. However, stroke events were also significantly influenced by previous stroke or transient ischemic attacks (hazard ratio, HR = 2.99, p < 0.001) and by previous bleeding events (HR = 1.60, p < 0.001).
Keywords: atrial fibrillation, thromboprophylaxis, real-practice, vitamin K antagonists,
stroke risk