[Atrial fibrillation, stroke and anticoagulation: under-use of warfarin?].
OBJECTIVE
To correlate the presence of non valvar atrial fibrillation (NVAF) and cardioembolic stroke in patients previously assisted by cardiologists and without restrictions to the use of warfarin, with the level of acceptance of the recommendations published about chronic AF among these professionals.


METHODS
All strokes accepted in two hospitals of Joinville were prospectively recorded. The patients with AF were questioned about their previous knowledge about arrythmia, the frequency they had seen their cardiologists and the use of warfarin. Later, 11 cardiologists answered to questions about AF, anticoagulation and stroke.


RESULTS
Among 167 patients with stroke, 22 were found with ischemic stroke and previous AF. Fifteen of them had previously seen by a cardiologist. Nine patients died, seven were discharged with warfarin and six did not have prescription of anticoagulant. The cardiologists answers presented that 91% of them knew these recommendations, although only 54 % found them applicable to public service's patients.


CONCLUSIONS
Considering that anticoagulation in NVAF reduces the relative stroke risk in 68% per year, we can conclude that 11 in 22 patients could have avoided the event. Thus, considering the stroke incidence in 1997 and current population in Joinville, we may speculate that currently 4% of all stokes per year in Joinville are potentially avoidable.
Cabral
Norberto L
NL
Universidade de Joinville, Joinville, SC, Brazil. cabral@neurologica.com.br
Volpato
Dalton
D
Ogata
Tatiana Rosa
TR
Ramirez
Tenille
T
Moro
Carla
C
Gouveia
Sergio
S
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications* / Q000401:mortality; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin