[Auricular fibrillation as a risk factor of cerebrovascular events in the over-65s. Is clinical practice in anticoagulant prophylaxis adequate?].

OBJECTIVE

To describe the clinical practice in antithrombotic therapy to prevent stroke in older patients with atrial fibrillation (AF).

METHODS

Cross-sectional study.

METHODS

Ourense's area with 95,840 inhabitants over 65 years.

METHODS

Patients over 65 with non rheumatic AF, chronic or paroxistic; 411 cases, 69.6% older than 75 year.

METHODS

Demographic characteristics, personal history, stroke risk, diagnostic characteristics of AF, antithrombotic treatment, and its adequacy.

RESULTS

Only 33% high risk patients received oral anticoagulation (OCA) with warfarin at diagnosis. Some features were found to be significant independent risk factors for OCA: age (older than 75 vs 65-74 years; odds ratio =0.32; 95% confidence interval, 0.18-0.59), and prior stroke (odds ratio =2.02; 95% confidence interval, 1.16-3.55).

CONCLUSIONS

Warfarin prophylactic is insufficiently prescribed, especially in older than 75 years (with high baseline risk of stroke and no counter-indications). There was inadequate prescription in 73.4% cases.