title: Evaluation of risk factors for stroke/embolism and of complications due to anticoagulant therapy in atrial fibrillation.
abstract: OBJECTIVE
  We sought to assess in outpatients with atrial fibrillation and oral anticoagulation (1) whether the complication rate is influenced by the presence of the risk factors age >65 years, arterial hypertension, diabetes, or previous stroke; (2) whether the complication rate is influenced by the number of additional drugs taken by patients; and (3) whether problems and interventions differ between patients with or without complications.
  
  
  METHODS
  - Clinical characteristics, drugs, problems, interventions, and complications were registered during 2 years.
  
  
  RESULTS
  - Three hundred sixty patients (mean age, 68 years; 43% female) were observed for 383 patient-years. Patients aged >65 years had more serious, life-threatening, or fatal complications (11% versus 5.3%/100 patient-years; P=0.0428) than younger patients. Patients with diabetes had more life-threatening and fatal complications (2.8% versus 0.6%/100 patient-years; P=0.0354) than patients without. The complication rate did not differ regarding the presence of previous stroke or hypertension. Patients who took </=3 drugs had fewer complications than patients who took more (4.3% versus 24.4%/100 patient-years; P=0.0041). Patients with complications complained more of chest (48% versus 28%/100 patient-years; P=0.0113) and abdominal pain (30% versus 13%/100 patient-years; P=0.0057), more frequently failed to keep appointments (134% versus 107%/100 patient-years; P=0.0321), had a higher tracking rate (134% versus 105%/100 patient-years; P=0.0272), and took more additional drugs (4.6 versus 3.5 drugs per day; P=0.0063) than patients with no complications.
  
  
  CONCLUSIONS
  - Patients with increased age or diabetes mellitus or those who take >3 drugs per day have an increased complication rate and thus need especially careful monitoring of oral anticoagulation, including adequate pain control.
authors.affiliation: Second Medical Department, KA Rudolfstiftung, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Wehinger
authors.forename: C
authors.initials: C
authors.lastname: Stöllberger
authors.forename: T
authors.initials: T
authors.lastname: Länger
authors.forename: B
authors.initials: B
authors.lastname: Schneider
authors.forename: J
authors.initials: J
authors.lastname: Finsterer
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D023381:Endpoint Determination; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D020766:Intracranial Embolism / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010644:Phenprocoumon / Q000008:administration & dosage / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000139:chemically induced / Q000150:complications / Q000175:diagnosis*
chemical_list: D000925:Anticoagulants; D010644:Phenprocoumon