About a quarter of U.S. atrial fibrillation patients under 60 years old and in otherwise good health received oral anticoagulants contrary to guidelines, according to a research letter from Dr. Jonathan Hsu of the University of California, San Diego, and his associates.
In patients in the National Cardiovascular Data Registry’s PINNACLE (Practice Innovation and Clinical Excellence) registry who had a CHADS2 and CHA2DS2-VASc score of zero, the average age of those who received oral anticoagulants was just under 51 years, compared with just over 46 years for those who did not receive oral anticoagulants. In addition to age, higher body mass index and having Medicare or no insurance vs. private insurance were associated with a higher prescription chance.
Patients treated in the South were significantly less likely to be prescribed anticoagulants than were those treated in the Northeast.
“Prescription of oral anticoagulants by cardiovascular specialists in a significant proportion of patients at the lowest thrombotic risk suggests that these health care professionals may not be fully aware of the potential risks associated with oral anticoagulation or the particularly low risk of stroke in this population,” the investigators concluded. Find the full research letter in JAMA Internal Medicine (doi:10.1001/jamainternmed.2015.0920).