title: Prevalence of oral anticoagulation in atrial fibrillation.
abstract: OBJECTIVE
  Atrial fibrillation is the most common sustained arrhythmia and is associated with poor outcomes, including stroke. The ability of anticoagulation therapy to reduce the risk of stroke has been well established; however, the prevalence of anticoagulation therapy use in the Public Health System is unknown. The aim of this study is to evaluate both the prevalence of anticoagulation therapy among patients with atrial fibrillation and the indications for the treatment.
  
  
  METHODS
  In this cross-sectional study, we included consecutive patients who had atrial fibrillation documented by an electrocardiogram performed between September 2011 and March 2012 at a university hospital of the Public Health System. The variables analyzed included the risk of a thromboembolic event and/or bleeding, the use of antiplatelet or anticoagulation therapy, the location where the electrocardiogram report was initially reviewed and the specialty of the physician who initially reviewed it.
  
  
  RESULTS
  We included 162 patients (mean age 68.9 years, 56% men). Hypertension (90.1%), heart failure (53.4%) and stroke (38.9%) were the most prevalent diseases found. Only 50.6% of the patients knew that they had atrial fibrillation. Regarding the use of therapy, only 37.6% of patients classified as high risk according to the CHADS2 scores and 35.5% according to the CHA2DS2VASc used oral anticoagulation. A presumptive diagnosis of heart failure and the fact that the electrocardiogram was evaluated by a cardiologist were the only independent predictors of the use of anticoagulants.
  
  
  CONCLUSIONS
  Our study found a low prevalence of oral anticoagulation therapy among patients with atrial fibrillation and an indication for stroke prophylaxis for the use of this therapy, including among those with high CHADS2 and CHA2DS2VASc scores.
authors.affiliation: Universidade Luterana do Brasil, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bartholomay
authors.affiliation: Universidade Luterana do Brasil, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Ismael
authors.initials: I
authors.lastname: Polli
authors.affiliation: Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Anibal Pires
authors.initials: AP
authors.lastname: Borges
authors.affiliation: Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Carlos
authors.initials: C
authors.lastname: Kalil
authors.affiliation: Universidade Luterana do Brasil, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Arroque
authors.affiliation: Universidade Luterana do Brasil, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Ilmar
authors.initials: I
authors.lastname: Kohler
authors.affiliation: Universidade Luterana do Brasil, Cardiology, Porto Alegre, RS, Brazil.
authors.forename: Luiz Cláudio
authors.initials: LC
authors.lastname: Danzmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications*; D003430:Cross-Sectional Studies; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control*; D013923:Thromboembolism / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants