title: [Use of oral anticoagulants in patients discharged with atrial fibrillation in 2000].
abstract: OBJECTIVE
  Although there is consensus about the use of oral anticoagulants to prevent thrombi and embolisms in most patients with atrial fibrillation, this treatment is underused in actual practice. Our objective was to determine and analyze the use of acenocoumarol in patients diagnosed as having atrial fibrillation at discharge.
  
  
  METHODS
  Between January and July 2000, we retrospectively studied 501 consecutive patients with a diagnosis of atrial fibrillation. We recorded whether they were discharged with or without oral anticoagulation treatment.
  
  
  RESULTS
  We identified 482 patients with at least one associated thromboembolic risk factor, who comprised the study population. Mean age was 79.3 years, and 33.3% of the patients were men. Forty-six percent were discharged with acenocoumarol, and 36.3% with platelet antiaggregants. Twenty-three percent had a known contraindication for acenoroumarol. Nearly 62% of the patients without contraindications for anticoagulation received treatment with acenocoumarol. Multivariate analysis showed that rheumatic mitral valve disease, previous stroke or thromboembolism and dilated left atrium were associated with a higher probability of receiving anticoagulant treatment. Age over 75 years was associated with a lower likelihood of receiving acenocoumarol.
  
  
  CONCLUSIONS
  Oral anticoagulation was given in an inadequate proportion of patients who were discharged from a secondary-level hospital with atrial fibrillation and no contraindications. Rheumatic mitral valve disease, previous stroke or thromboembolism, and dilated left atrium were associated with a higher probability of anticoagulant treatment. Age over 75 years was related with less frequent use of this therapy.
authors: Servicio de Cardiología. Hospital Dos de Maig. Consorci Sanitari Integral. Barcelona. España. pere.blanch@consorcicreuroja.es
authors: Pedro
authors: P
authors: Blanch
authors: Roman
authors: R
authors: Freixa
authors: Montserrat
authors: M
authors: Ibernón
authors: Javier
authors: J
authors: Delso
authors: Elena
authors: E
authors: Salas
authors: José L
authors: JL
authors: Sobrepera
authors: Jaume
authors: J
authors: Padró
authors: Laura
authors: L
authors: Dos
authors: Pedro
authors: P
authors: Codinach
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000925:Anticoagulants