Real life anticoagulant treatment for stroke prevention in patients with nonvalvular atrial fibrillation

Abstract

Atrial fibrillation (AF) represents the most frequent cause of cardioembolic stroke. The aim of the study was to evaluate the patterns of anticoagulant treatment in patients admitted for stroke due to non-valvular atrial fibrillation (NVAF). The main inclusion criteria in the study was the diagnosis of cardioembolic stroke in patients admitted to our hospital between November 2016 and February 2017. We evaluated different subtypes of AF related to stroke. A number of 108 patients with NVAF were included. Of the 90 patients known with NVAF, 41 had received recommendation for anticoagulant therapy, but only 27 followed the treatment. An important percentage of patients with stroke, treated with vitamin K antagonists (VKA), were not optimally anticoagulated, being at risk both for thromboembolic risk and haemorrhagic events. An important percentage of patients with stroke, treated with VKA, are not optimally controlled (INR outside the therapeutic range), exposing them at risk for thromboembolic and also haemorrhagic events. In real life settings, in Romania, only a small number of patients with NVAF receive NOAC treatment.