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Multicenter Study
. 2004 Jun;57(6):798-806.
doi: 10.1111/j.1365-2125.2004.02086.x.

Stroke prevention and atrial fibrillation: reasons leading to an inappropriate management. Main results of the SAFE II study

Dominique Deplanque  1 , Didier Leys, Lucilla Parnetti, Reinhold Schmidt, Jose Ferro, Jacques De Reuck, Jean-Louis Mas, Virgilio Gallai; SAFE II Investigators
Affiliations
Multicenter Study

Stroke prevention and atrial fibrillation: reasons leading to an inappropriate management. Main results of the SAFE II study

Dominique Deplanque et al. Br J Clin Pharmacol. 2004 Jun.

Abstract

Aims: The aim of the Stroke and Atrial Fibrillation Ensemble (SAFE) II study was to identify the reasons underlying the under-utilization of oral anticoagulation (OAC) in patients with nonvalvular atrial fibrillation (NVAF).

Methods: We investigated from all available sources the reasons why patients hospitalized for a stroke, who had a previously known NVAF, were not receiving OAC beforehand. We interviewed general practitioners (GPs) and cardiologists with a structured questionnaire, to identify the reasons for their therapeutic choice.

Results: Of 370 patients, 257 were theoretically eligible for OAC according to guidelines and the presence of contra-indications, but only 82 (22.2%) of them had actually received OAC before. We found that factors independently associated with the prescription of OAC were being followed-up by a cardiologist and having a younger GP. The leading reason evoked by GPs or cardiologists to explain why patients were not treated with OAC was the presence of a 'potential contra-indication', which was often inappropriate, followed by 'there was no indication', 'low compliance' and 'fear of bleeding'.

Conclusions: An important reason for not prescribing OAC was the lack of knowledge about trials and guidelines. Medical education about OAC in NVAF should therefore be improved.

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References

    1. Wolf PA, D'Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22:312–8. - PubMed
    1. Wolf PA, Dawber TR, Thomas HE, Jr, Kannel WB. Epidemiological assessment of chronic atrial fibrillation and the risk of stroke: the Framingham Study. Neurology. 1978;28:973–7. - PubMed
    1. Jørgensen HS, Nakayama H, Reith J, Raasschou HO, Olsen TS. Acute stroke with atrial fibrillation: the Copenhagen Stroke Study. Stroke. 1996;10:1765–9. - PubMed
    1. Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation: the Framingham Study. Stroke. 1996;27:1760–4. - PubMed
    1. The Stroke Prevention in Atrial Fibrillation Investigators. Predictors of thromboembolism in atrial fibrillation. I. Clinical features of patients at risk. Ann Intern Med. 1992;116:1–5. - PubMed

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