Is warfarin still underused in patients with atrial fibrillation? A major threat to treatment benefit.
Summary of "Is warfarin still underused in patients with atrial fibrillation? A major threat to treatment benefit."
Atrial fibrillation may cause thromboembolic events and the risk of thromboembolic events increase with the number of clinical and echocardiographic risk factors. Although the benefit of anticoagulant therapy in preventing thromboembolic events was clearly shown, a significant number of patients with atrial fibrillation were not under anticoagulant therapy. However, whatever the patient's reason for warfarin underutilisation, probably it is the main obstacle for reducing stroke risk in atrial fibrillation. Consequently, it makes the use of any risk factor calculation useless.
Affiliation
Journal Details
This article was published in the following journal.
Name: International journal of cardiology
ISSN: 1874-1754
Pages: 439-40
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/19346015
- DOI: http://dx.doi.org/10.1016/j.ijcard.2009.03.073
Medical and Biotech [MESH] Definitions
Warfarin
An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.
Atrial Flutter
Rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES).
Digoxin
A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)
Ventricular Fibrillation
A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST.
Atrial Premature Complexes
A type of cardiac arrhythmia with premature atrial contractions or beats caused by signals originating from ectopic atrial sites. The ectopic signals may or may not conduct to the HEART VENTRICLES. Atrial premature complexes are characterized by premature P waves on ECG which are different in configuration from the P waves generated by the normal pacemaker complex in the SINOATRIAL NODE.
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To the Editor: Olesen et al. (Aug. 16 issue)(1) report that in their study, warfarin treatment was associated with a decreased risk of thromboembolic events among patients requiring renal-replacement...
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