Risk of discontinuation increased with previous intracranial bleeding, excessive alcohol use, anemia
TUESDAY, Sept. 6, 2016 (HealthDay News) — Among patients with atrial fibrillation (AF), the proportion of warfarin persistence is 0.91 at one year and 0.73 at four years, according to a study published online Aug. 27 in Cardiovascular Therapeutics.
Fredrik Björck, M.D., from Umeå University in Sweden, and colleagues examined warfarin persistence in AF patients. Data were included for 478 patients from the national quality register AuriculA for all AF patients in Sundsvall, Sweden.
The researchers found that after one year and four years, the proportion of warfarin persistence was 0.91 and 0.73, respectively. The risk of discontinuation was increased with previous intracranial bleeding, excessive alcohol use, anemia, and pulmonary or peripheral emboli (hazard ratios, 5.66, 2.54, 2.40, and 2.13, respectively). About half (50.5 percent) of discontinuations were due to questionable causes, including sinus rhythm, patient demand, and falls (33.9, 10.1, and 8.2 percent, respectively). Most treatment discontinuers were changed to aspirin (43.1 percent), and many were left without medical stroke prophylaxis (40.4 percent).
“Although persistence to warfarin among AF patients proves higher than previously reported, there is room for improvement since half of the discontinuers have questionable reasons for treatment stop and the majority of them receive no other efficient stroke prophylaxis,” the authors write.
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