title: [A prospective protocol increases oral anticoagulant prescription in patients with chronic, nonvalvular atrial fibrillation].
abstract: OBJECTIVE
  Observational studies have shown that oral anticoagulants (OAC) prescription is suboptimal in patients with nonvalvular atrial fibrillation (NVAF). Our objective was to evaluate the usefulness of a prospective protocol for increasing OAC usage in these patients.
  
  
  METHODS
  From 1 February 2000 until 31 October 2002 we enrolled all patients with chronic NVAF seen in two outpatient cardiology clinics, excluding candidates for cardioversion. Each patient was studied to identify cardioembolic risk factors (CERF) and contraindications for OAC. Anticoagulation was suggested to all patients with > or =2 CERF and without contraindications for OAC. The decision to prescribe OAC was made by the physician in charge when there was only one CERF.
  
  
  RESULTS
  721 patients fulfilled the inclusion criteria. Mean age was 73 +/- 8 years; 44% were men. In most cases NVAF was related with hypertension (57%), followed by no structural heart disease (25%) or ischemic heart disease (9%). The most frequent CERFs were hypertension (66%), age > or =75 years (45%) and diabetes (24%). A total of 663 patients had > or =1 CERF (92%), and 125 (19%) of these presented at least one contraindication for OAC. Of the 538 remaining patients (90%), 485 (67% of the whole series) were treated with anticoagulation. Of the patients with > or =2 CERF and without contraindications for OAC, 95% were treated.
  
  
  CONCLUSIONS
  A prospective protocol for use in the outpatient cardiology clinic allows to prescribe OAC in a large percentage of patients with NVAF.
authors.affiliation: Servicio de Cardiología, Hospital Reina Sofía, Córdoba, España. mruor@supercable.es
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz Ortiz
authors.forename: Elías
authors.initials: E
authors.lastname: Romo Peñas
authors.forename: Manuel
authors.initials: M
authors.lastname: Franco Zapata
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa Rubio
authors.forename: Manuel
authors.initials: M
authors.lastname: Anguita Sánchez
authors.forename: Amador
authors.initials: A
authors.lastname: López Granados
authors.forename: José M
authors.initials: JM
authors.lastname: Arizón del Prado
authors.forename: Federico
authors.initials: F
authors.lastname: Vallés Belsué
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002908:Chronic Disease; D002985:Clinical Protocols; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000925:Anticoagulants