Antithrombotic Therapy for Atrial Fibrillation

Patients with atrial fibrillation (AF) are at high risk for thromboembolism if they are older (age, >75); have cardiovascular risk factors such as prior ischemic stroke, transient ischemic attack, systemic embolism, left ventricular systolic dysfunction, or congestive heart failure; or have hypertension or diabetes (Chest 2004; 126:429S). Logically, all such patients should be protected with antithrombotic therapy, but, in a recent study, investigators found otherwise.

Researchers from the Group Health Cooperative in Seattle reviewed the records of 596 patients with newly diagnosed AF. Of 437 patients (76%) who were at high risk for thromboembolism, 24% did not receive antithrombotic therapy, and the rest were treated with warfarin (48%), as…