A-Fib + Stroke Patients Not Getting Proper Medications Post-Discharge

the MPR take:

Despite current guidelines, many patients with atrial fibrillation (A-fib) and ischemic stroke (IS) are not receiving antithrombotic therapy after hospital discharge or are receiving antiplatelet therapy alone, increasing their risk of major vascular events. Two thousand one hundred sixty-two patients from the Ontario Stroke Registry were hospitalized for A-fib and acute IS; at discharge, 8.0% were prescribed no antithrombotic therapy, 21.6% antiplatelet therapy alone, 39.3% oral anticoagulation (OAC; warfarin) alone, and 31.1% combination OAC and antiplatelet therapy. No antithrombotic therapy and antiplatelet therapy alone were associated with an increased risk of major vascular events, but combination OAC and antiplatelet therapy was associated with a trend towards a reduced risk. Because OAC alone is recommended in present guidelines, evaluation of combination OAC and antiplatelet therapy in clinical trials merits further research.

Background and Purpose- For patients with atrial fibrillation and ischemic stroke (IS), current guidelines recommend oral anticoagulation (OAC) alone for secondary prevention of IS. At discharge, 8.0% were prescribed no antithrombotic therapy, 21.6% antiplatelet therapy alone, 39.3% OAC (warfarin) alone, and 31.1% combination OAC and antiplatelet therapy.

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