American Journal of Cardiology
Volume 105, Issue 8 , Pages 1130-1134 , 15 April 2010

Warfarin and Aspirin Use in Atrial Fibrillation Among Practicing Cardiologist (from the AFFECTS Registry)

  • Peter R. Kowey, MD

      Affiliations

    • Jefferson Medical College, Philadelphia, Pennsylvania
    • Corresponding Author InformationCorresponding author: Tel: (610) 645-2684; fax: (610) 896-0643
    • ,
  • James A. Reiffel, MD

      Affiliations

    • Columbia University, New York, New York
    • ,
  • Robert Myerburg, MD

      Affiliations

    • University of Miami, Miami, Florida
    • ,
  • Gerald V. Naccarelli, MD

      Affiliations

    • Penn State College of Medicine, Hershey, Pennsylvania
    • ,
  • Douglas L. Packer, MD

      Affiliations

    • Mayo Clinic, Rochester, Minnesota
    • ,
  • Craig M. Pratt, MD

      Affiliations

    • Baylor College of Medicine, Houston, Texas
    • ,
  • Michael J. Reiter, MD, PhD

      Affiliations

    • University of Colorado, Denver, Colorado
    • ,
  • Albert L. Waldo, MD

      Affiliations

    • University Hospitals Case Medical Center, Cleveland, Ohio
    • ,
  • AFFECTS Scientific Advisory Committee and Investigators

References 

  1. Fuster V, Ryden LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary (A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation): developed in Collaboration With the North American Society of Pacing and Electrophysiology). J Am Coll Cardiol. 2001;38:1231–1266
  2. Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e257–e354
  3. McCormick D, Gurwitz JH, Goldberg RJ, Becker R, Tate JP, Elwell A, et al. Prevalence and quality of warfarin use for patients with atrial fibrillation in the long-term care setting. Arch Intern Med. 2001;161:2458–2463
  4. Sudlow M, Thomson R, Thwaites B, Rodgers H, Kenny RA. Prevalence of atrial fibrillation and eligibility for anticoagulants in the community. Lancet. 1998;352:1167–1171
  5. Boulanger L, Hauch O, Friedman M, Foster T, Dixon D, Wygant G, et al. Warfarin exposure and the risk of thromboembolic and major bleeding events among Medicaid patients with atrial fibrillation. Ann Pharmacother. 2006;40:1024–1029
  6. Gladstone DJ, Bui E, Fang J, Laupacis A, Lindsay MP, Tu JV, et al. Potentially preventable strokes in high-risk patients with atrial fibrillation who are not adequately anticoagulated. Stroke. 2009;40:235–240
  7. Glazer NL, Dublin S, Smith NL, French B, Jackson LA, Hrachovec JB, et al. Newly detected atrial fibrillation and compliance with antithrombotic guidelines. Arch Intern Med. 2007;167:246–252
  8. Waldo AL, Becker RC, Tapson VF, Colgan KJ. Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation. J Am Coll Cardiol. 2005;46:1729–1736
  9. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–1833
  10. Van Gelder IC, Hagens VE, Bosker HA, Kingma JH, Kamp O, Kingma T, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med. 2002;347:1834–1840
  11. Reiffel JA, Kowey PR, Myerburg R, Naccarelli GV, Packer DL, Pratt CM, et al. Practice patterns among United States cardiologists for managing adults with atrial fibrillation (from the AFFECTS registry). Am J Cardiol. 2010;105:1122–1129
  12. Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285:2864–2870
  13. Sherman DG, Kim SG, Boop BS, Corley SD, Dimarco JP, Hart RG, et al. Occurrence and characteristics of stroke events in the Atrial Fibrillation Follow-up Investigation of Sinus Rhythm Management (AFFIRM) study. Arch Intern Med. 2005;165:1185–1191
  14. Nieuwlaat R, Capucci A, Lip GY, Olsson SB, Prins MH, Nieman FH, et al. Antithrombotic treatment in real-life atrial fibrillation patients: a report from the Euro Heart Survey on Atrial Fibrillation. Eur Heart J. 2006;27:3018–3026
  15. Nieuwlaat R, Dinh T, Olsson SB, Camm AJ, Capucci A, Tieleman RG, et al. Should we abandon the common practice of withholding oral anticoagulation in paroxysmal atrial fibrillation?. Eur Heart J. 2008;29:915–922
  16. Hohnloser SH, Pajitnev D, Pogue J, Healey JS, Pfeffer MA, Yusuf S, et al. Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W substudy. J Am Coll Cardiol. 2007;50:2156–2161
  17. Allen Lapointe NM, Sun JL, Kaplan S, d'Almada P, Al-Khatib SM. Rhythm versus rate control in the contemporary management of atrial fibrillation in-hospital. Am J Cardiol. 2008;101:1134–1141
  18. Go AS, Hylek EM, Chang Y, Phillips KA, Henault LE, Capra AM, et al. Anticoagulation therapy for stroke prevention in atrial fibrillation: how well do randomized trials translate into clinical practice?. JAMA. 2003;290:2685–2692
  19. Nieuwlaat R, Olsson SB, Lip GY, Camm AJ, Breithardt G, Capucci A, et al. Guideline-adherent antithrombotic treatment is associated with improved outcomes compared with undertreatment in high-risk patients with atrial fibrillation (Euro Heart Survey on Atrial Fibrillation). Am Heart J. 2007;153:1006–1012
  20. Fang MC, Go AS, Chang Y, Borowsky L, Pomernacki NK, Singer DE. Comparison of risk stratification schemes to predict thromboembolism in people with nonvalvular atrial fibrillation. J Am Coll Cardiol. 2008;51:810–815
  21. Stroke Risk in Atrial Fibrillation Working Group. Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillation. Stroke. 2008;39:1901–1910
  22. Connolly S, Pogue J, Hart R, Pfeffer M, Hohnloser S, Chrolavicius S, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial Fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367:1903–1912
  23. Connolly SJ, Pogue J, Hart RG, Hohnloser SH, Pfeffer M, Chrolavicius S, et al. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med. 2009;360:2066–2078

 This study was supported by Reliant Pharmaceuticals, acquired by GlaxoSmithKline, Research Triangle Park, North Carolina, and was sponsored by Columbia University, New York, New York.

 All listed authors met the criteria for authorship set forth by the International Committee for Medical Journal Editors.

 The AFFECTS Registry was overseen by a Scientific Advisory Committee comprised of Peter R. Kowey, MD, Robert J. Myerburg, MD, Gerald V. Naccarelli, MD, Douglas Packer, MD, Craig M. Pratt, MD, Eric N. Prystowsky, MD, James A. Reiffel, MD, Michael Reiter, MD, PhD, and Albert L. Waldo, MD.

 The full list of investigators appears in the Appendix to the online version of this report.

PII: S0002-9149(09)02844-6

doi: 10.1016/j.amjcard.2009.11.047

American Journal of Cardiology
Volume 105, Issue 8 , Pages 1130-1134 , 15 April 2010

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