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 In-patient 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.