Many patients with atrial fibrillation (irregular heartbeat) are not receiving stroke-prevention treatments. This is problematic because having atrial fibrillation is a known risk factor for stroke. Lead study author Dr. Jonathan Hsu said, “The findings of our study are surprising given that these patients with atrial fibrillation were treated by a cardiovascular specialist, who should be aware of guideline recommendations.”
The researchers tracked over 400,000 atrial fibrillation patients in the U.S. over the course of four years. The researchers found that majority of patients were prescribed blood-thinners at some point, but over 50 percent of patients at the highest risk for stroke were not on prescription blood-thinners.
Hsu suggests part of the problem is patient preference. Patients may not be inclined to take medication and so doctors respect their wishes. On the other hand, doctors may put too much pressure on the risk of bleeding, which can occur with blood thinners, and so they steer clear of them unless utterly necessary.
One-quarter of Americans are at risk for developing atrial fibrillation, which is a condition characterized by electrical irregularities that prompt the upper chambers of the heart to function abnormally. Atrial fibrillation increases the risk of blood clotting and stroke by up to five times, compared to someone without atrial fibrillation.
There is much supporting evidence to prescribe blood thinners to atrial fibrillation patients, as Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, pointed out, “This study shows a very serious issue, in that these patients are facing excess risk of cardioembolic strokes that could have been prevented.”
Hsu added with regards to the findings, “The fact that there seemed to be a plateau of oral anticoagulation prescription of those at highest risk of stroke should be a wake-up call to all of us who treat patients with atrial fibrillation.”
The findings were published in JAMA Cardiology.