Abstract Details

Title High Prevalence of Atrial Fibrillation Patients without Anti-Thrombotic Therapy: An Important Target for Primary Stroke Prevention

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 050

Objective

Background BACKGROUND: AF is an important risk factor. It increases the annual risk for stroke by fivefold and accounts for 15% of all strokes. Even though antithrombotic therapy reduces the rate of stroke and mortality, it is underused to variable degrees worldwide. Few studies have presented the prevalence of untreated AF among patients presenting with first ischemic stroke to demonstrate the disease burden of known, untreated AF.

Design/Methods DESIGN/METHODS: In this prospective study, patients admitted to a tertiary hospital's neurology service for acute ischemic stroke were recruited from September 2009 to August 2011. Data on their disease profile and presence of AF treatment (antiplatelet or anticoagulation (with achievement of therapeutic levels)) on admission was collected. Chi2 and logistic regression analyses were applied.

Results RESULTS: 514 patients were studied with mean age 66.7 ± 12.9 years. Of these, 15.9% had stroke attributable to AF. 12.1% had known AF. Despite all of these patients being of intermediate to high risk according to the CHA(2)DS(2) VASc score , 43.6% (n=27) of known AF were not on any form of antithrombotic therapy. Of the 6.5% (n=4) with intermediate risk for stroke, 25% (n=1) were on antiplatelet therapy. Of the 93.6% (n=58) with high risk, 56.9% (n=33) were on antiplatelet therapy; only 1.72% (n=1) was on therapeutic anticoagulation. Antithrombotic therapy for AF was associated with pre-morbid independence (modified Rankin Scale 0-2), (85.7% vs 63%, OR 3.529, 95%CI 1.04 - 12.04 p=0.044) but independent of co-morbidities and stroke risk.

Conclusions CONCLUSIONS: Despite known high risk for stroke among patients with AF, the prevalence of treatment is low. Further research is needed to explore reasons behind the absence of antithrombotic treatment and patients' refusal. Enablers of good pre-morbid function are helpful in prevention of stroke among AF patients.

Authors/Disclosures
Orlanda Goh, MD (Singapore Health Services) PRESENTER	No disclosure on file
Tian Ming Tu, MD (Neurology Care Partners)	Dr. Tu has nothing to disclose.
	No disclosure on file
	No disclosure on file
Kim En Lee, MBBS, MRCP (Lee Kim En Neurology Pte Ltd)	No disclosure on file
Victoria Barghout, PhD	No disclosure on file

��ɫ��

��ɫ��