Reply Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed

We are appreciative of Dr. Brown and colleagues and their interest in our recent paper in theJournal(1) regarding prescription of aspirin instead of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) who are at intermediate-to-high thromboembolic risk in the American College of Cardiology National Cardiovascular Data Registry ’s PINNACLE (Practice Innovation and Clinical Excellence) Registry. They appropriately highlight some of our main findings, including that OAC prescription was selected in 61.8% of patients with a CHADS2 score  ≥2 (meaning 38.2% of patients were treated with aspirin alone) and 59.8% of patients with a CHA2DS2-VASc score  ≥2 (meaning 40.2% of patients were treated with aspirin alone). The main focus of our study was on the prevalence of aspirin-only treatment and predictors of this practice in the face of guideline recommendations that promote OAC over aspirin for thromboembolism prevention in at-risk AF patients . In their letter, Dr. Brown and colleagues astutely point out that although not ideal, the 62% prescription prevalence of OAC appears to be an improvement compared with previous data on OAC prescription rates both before and after the introduction of direct oral anticoagulants(2).
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research