Author + information
Patients with paroxysmal atrial fibrillation (AF) experience a similar risk of embolization compared to patients with persistent AF. Although consensus guidelines call for anticoagulant therapy in those at risk for thromboembolism irrespective of AF classification, differences may exist in the appropriate treatment of AF patients in real-world practice.
We identified patients with AF and intermediate to high thromboembolic risk (CHADS2 score ≥ 2) enrolled in the ACC NCDR-PINNACLE Registry between July, 2008 and June, 2012. Using hierarchical modified Poisson regression models adjusted for patient characteristics, we examined whether antithrombotic treatment differed between patients with paroxysmal versus persistent AF.
Of 62,018 identified patients, 46,458 (74.9%) had paroxysmal and 15,560 (25.1%) had persistent AF. Paroxysmal AF was associated with less frequent treatment with anticoagulant therapy (48.1% vs. 58.4%), more frequent treatment with antiplatelet therapy (34.2% vs. 24.2%), and failure to treat with any therapy (17.7% vs. 17.4%), in unadjusted and multivariable adjusted analyses (Figure). In subgroup analysis, younger age (<75 years) was associated with significantly less use of oral anticoagulation in paroxysmal versus persistent AF patients (p value for interaction <0.001).
In a large, real-world cardiac outpatient population, paroxysmal AF patients were less likely to be prescribed appropriate anticoagulant therapy.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmia Outcomes and Quality Assessment
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1245-113
- 2013 American College of Cardiology Foundation