Prescribing anticoagulants in the ED for atrial fibrillation increases long-term use by 30%

December 09, 2019

Podcast permanent link: https://soundcloud.com/cmajpodcasts/190747-res

Patients prescribed anticoagulants after a diagnosis of atrial fibrillation in the emergency department are more likely to continue long-term use of medications to treat the condition, according to research published in CMAJ (Canadian Medical Association Journal).

"In this multicentre study in Ontario, Canada, providing an oral anticoagulant prescription in the emergency department to patients with atrial fibrillation who were older than 65 years was associated with a marked increase in long-term use of this therapy," writes Dr. Clare Atzema, a senior scientist with ICES and the Division of Emergency Medicine, University of Toronto, with coauthors.

More than 33 million people around the world have atrial fibrillation, that is, an irregular heart beat that is associated with a fivefold increased risk of stroke as well as other cardiac issues. Use of oral anticoagulants can decrease stroke risk by 60%.

Usual practice is to refer patients seen in the emergency department for atrial fibrillation to primary care or a cardiologist for anticoagulant prescription and follow-up.

In this study performed at 15 centres in Ontario, researchers found that if an oral anticoagulant was prescribed in the emergency department to patients aged 65 years or older who were not at high risk of bleeding, there was a 31% absolute increase in the tendency to fill the prescription at 6 months, compared with referral to the patient's physician to consider starting the medication.

"Physicians working in the emergency department should consider initiating oral anticoagulants in similar patients [patients with atrial fibrillation] who are being discharged home, because this action is associated with improved use of stroke prevention long after the patient leaves the emergency department," the authors recommend.

"Prescribing of oral anticoagulants in the emergency department and subsequent long-term use by older adults with atrial fibrillation" is published December 9, 2019.
-end-


Canadian Medical Association Journal

Related Stroke Articles from Brightsurf:

Stroke alarm clock may streamline and accelerate time-sensitive acute stroke care
An interactive, digital alarm clock may speed emergency stroke care, starting at hospital arrival and through each step of the time-sensitive treatment process.

Stroke patients with COVID-19 have increased inflammation, stroke severity and death
Stroke patients who also have COVID-19 showed increased systemic inflammation, a more serious stroke severity and a much higher rate of death, compared to stroke patients who did not have COVID-19, according a retrospective, observational, cross-sectional study of 60 ischemic stroke patients admitted to UAB Hospital between late March and early May 2020.

'Time is vision' after a stroke
University of Rochester researchers studied stroke patients who experienced vision loss and found that the patients retained some visual abilities immediately after the stroke but these abilities diminished gradually and eventually disappeared permanently after approximately six months.

More stroke awareness, better eating habits may help reduce stroke risk for young adult African-Americans
Young African-Americans are experiencing higher rates of stroke because of health conditions such as high blood pressure, diabetes and obesity, yet their perception of their stroke risk is low.

How to help patients recover after a stroke
The existing approach to brain stimulation for rehabilitation after a stroke does not take into account the diversity of lesions and the individual characteristics of patients' brains.

Kids with headache after stroke might be at risk for another stroke
A new study has found a high incidence of headaches in pediatric stroke survivors and identified a possible association between post-stroke headache and stroke recurrence.

High stroke impact in low- and middle-income countries examined at 11th World Stroke Congress
Less wealthy countries struggle to meet greater need with far fewer resources.

Marijuana use might lead to higher risk of stroke, World Stroke Congress to be told
A five-year study of hospital statistics from the United States shows that the incidence of stroke has risen steadily among marijuana users even though the overall rate of stroke remained constant over the same period.

We need to talk about sexuality after stroke
Stroke survivors and their partners are not adequately supported to deal with changes to their relationships, self-identity, gender roles and intimacy following stroke, according to new research from the University of Sydney.

Standardized stroke protocol can ensure ELVO stroke patients are treated within 60 minutes
A new study shows that developing a standardized stroke protocol of having neurointerventional teams meet suspected emergent large vessel occlusion (ELVO) stroke patients upon their arrival at the hospital achieves a median door-to-recanalization time of less than 60 minutes.

Read More: Stroke News and Stroke Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.