Anticoagulation Therapy in High Risk Patients with Atrial Fibrillation: Retrospective Study in a Regional Hospital

Objective: to evaluate the usage of warfarin in high risk of stroke patients with atrial fibrillation using chads2 score. design: retrospective case reviews using hospital inpatient enquiry (h.i.p.e) system. methods: this study was carried out on 218 patients admitted in our hospital with atrial fibrillation in last 5 years. their chads2 score was calculated. we tried to identify the proportion of the patients with chads2 score of .3 (high risk) and their anticoagulation status on admission. results: out of 218 patients, 130 (60%) were males and 88 (40%) were females. average age was 71.8 years. heart failure, hypertension and previous history of stroke or tia was identified in 46.3%, 39% and 23% respectively. on admission, 26% were on warfarin, 60% were on aspirin. 66 patients (30.3%) were identified as high risk (chads2 score of .3). only 18 (27%) of these high risk patients were on warfarin. conclusions: the results showed that less than one-third of high risk patients were on warfarin despite having no absolute contraindications. however, >60% of these patients were on aspirin. more frequent use of warfarin and further large scale trial is recommended.