Revisiting the Decision to Not Prescribe Oral Anticoagulation for Patients with Nonvalvular Atrial Fibrillation

Some patients with nonvalvular atrial fibrillation (AF) do not receive oral anticoagulation, although the rate has increased in recent years due to the convenience of direct-acting oral anticoagulants (DOACs) compared with warfarin. In this study, U.S. researchers identified 817 patients with nonvalvular AF (median age, 76; median CHA2DS2-VASc score, 4 [minimum score, 2]) who were not receiving oral anticoagulation; in ≈80% of patients, anticoagulation was deemed to be definitely or probably appropriate. Patients and their physicians were surveyed to assess perceptions of risks, benefits, and appropriateness of oral anticoagulation.

In the total cohort of 817 patients, 311 (38%) would have agreed to receive anticoagulants. An additional 216 …