Anticoagulation use and predictors of stroke, bleeding and mortality in multi-ethnic Asian patients with atrial fibrillation: A single centre experience
- Author:
Pow Li Chia
;
Xuhiu Teoh
;
Jonathan Cheng Ming Hua
;
Ming Er Ching
;
David Chee Guan Foo
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Stroke;
Anticoagulation
- From:
The Medical Journal of Malaysia
2016;71(5):256-258
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Atrial fibrillation (AF) is the most common
cardiac arrhythmia in singapore. We describe a cohort of
multi-ethnic Asian patients with AF, with the aim to evaluate
anticoagulation use and to identify factors predictive of
stroke, bleeding and all-cause mortality.
Materials and Methods: this was a single centre,
retrospective cohort study. All patients with an admission
diagnosis of AF between 1 January 2000 and 31 December
2010 were identified. Of these patients, those who had
follow-up data up to 31 December 2012 were included in the
study.
results: there were 1095 eligible patients. the mean age
was 67±14 years, mean cHADs2 score was 2±1 and mean
HAs-bLED score 2±1. Of the 1095 patients, 657 (62.0%) had
a cHADs2 score ≥ 2 but only 215 (32.7%) were eventually
prescribed warfarin. Patients not on warfarin were older
(p<0.0001) and were more likely females (p<0.0001). Among
patients not on warfarin, 52% had HAs-bLED score ≤3.
Multivariate analysis revealed that warfarin use and high
HAs-bLED score were associated with increased bleeding
risk. Age, Indian ethnicity and cHADs2 score were
predictive of ischemic stroke. All-cause mortality was
significantly related to age, presence of heart failure and
HAs-bLED score.
conclusions: Anticoagulation management of AF patients
remains inadequate. Objective assessment of bleeding risks
should be performed before withholding anticoagulation.
- Full text:P020170208343579134561.pdf
