HRS: Registry data point to shortfall in anticoagulant therapy

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 - mind the gap, disparity

Patients with paroxysmal atrial fibrillation (AF) were less likely to receive guideline recommended anticoagulation therapy compared with persistent AF patients. The analysis presented May 8 at the Heart Rhythm Society scientific sessions in Denver included registry data on more than 62,000 patients.

Jonathan C. Hsu, MD, of the University of California in San Francisco, and colleagues identified 46,458 patients with paroxysmal AF and 15,560 with persistent AF enrolled in the American College of Cardiology’s PINNACLE Registry, part of the National Cardiovascular Data Registry. The patients were at intermediate to high risk of thromboembolic events; anticoagulation therapy is recommended for both AF groups to reduce that risk.

Hsu et al found that oral anticoagulation therapy was less frequent in the paroxysmal AF group compared with the persistent AF group (48.1 percent vs. 58.4 percent) but antiplatelet therapy was more frequent (34.2 percent vs. 24.2 percent). Younger age (75 years old or less) was associated with significantly less frequent use of oral anticoagulants in paroxysmal AF patients, according to the researchers.

Failure to treat with any therapy was 17.7 percent in the paroxysmal AF group and 17.4 percent in the persistent AF group.

The results held up in both unadjusted and multivariable adjusted analyses. They defined oral anticoagulant therapy as warfarin, dabigatran (Pradaxa, Boehringer Ingelheim), or rivaroxaban (Xarelto, Janssen Pharmaceuticals/Bayer Healthcare) and antiplatelet therapy as aspirin, any thienopyridine or dipyridamole.