Editorial Comment: Oral anticoagulation in atrial fibrillation: are the problems solved?

The prevalence of atrial fibrillation (AF) is high and it is expected to increase in the near future (1). AF is a strong inde- pendent risk factor for ischemic stroke and systemic arterial embolisation (2). Oral anticoagulation (OAC) has been shown to decrease the risk of stroke. In a meta-analysis of 6 randomized trials including 2900 participants, the estimated relative risk reduction is reported as 64% (3). Despite the evident benefits, OAC is underused even in high-risk AF patients (4, 5). The study by Elezi et al. (6) provides an interesting retrospec- tive analysis of the prescription of OACs in patients with AF in a single tertiary centre in Kosovo. The main finding is the low per- centage of OAC use in patients with AF when compared with the previous studies. It is reported that only less than 1/3 of patients with primary or secondary diagnosis of AF were discharged on anticoagulation therapy. Elder age, normal left atrial size, and preserved ejection fraction were the independent predictors of underprescription of anticoagulants.