[Nonvalvular atrial fibrillation: thromboembolic risk assessment and therapy in a general practice population].
BACKGROUND
Cardiologists may prescribe antithrombotic therapy to patients with atrial fibrillation (AF), but prescription application mostly depends on general practitioners. The present study aims to assess frequency and appropriateness of antithrombotic therapy in general practice, as a function of thromboembolic risk factors, using the CHADS2 score.


METHODS
The computer records of 39 general practitioners were evaluated in order to identify patients with non-valvular AF; therapy and thromboembolic risk factors were recorded.


RESULTS
AF was documented in 951 patients; 96 (10.1%) had contraindications to oral anticoagulants. Among the remaining 850 patients, 292 (34.4%) did not receive antithrombotic therapy according to guidelines. In particular, 102 (12.0%) did not receive any antithrombotic treatment.


CONCLUSIONS
Among general practitioners of the Veneto region (Italy), the application of guidelines on antithrombotic therapy in non-valvular AF is comparable, or even slightly better than that reported in published cohort studies, but it deserves further improvement. There is a need for targeted educational interventions and a better coordination between cardiologists and general practitioners.
Del Zotti
Francesco
F
Divisione Clinicizzata di Cardiologia, A.O. Istituti Ospitalieri, Verona.
Gottardi
Giobatta
G
Frapporti
Guglielmo
G
Micchi
Alessio
A
Zanolla
Luisa
L
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications*; D002309:Cardiology; D015331:Cohort Studies; D015897:Comorbidity; D004363:Drug Utilization; D005194:Family Practice; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019983:Guideline Adherence; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012720:Severity of Illness Index; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology*
D000925:Anticoagulants; D005343:Fibrinolytic Agents