Use of vitamin K antagonists for secondary stroke prevention depends on the treating healthcare provider in Germany - results from the German AFNET registry
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
- Institut für Pharmakologie und Toxikologie
- Ludwig-Maximilians-Universität München (LMU)
- Institut für Herzinfarktforschung
- Klinikum Lippe
- Universitätsklinikum Brandenburg an der Havel
- Universität Hamburg
- Institut für Pharmakologie und Toxikologie
- Westfälische Wilhelms-Universität Münster
- University of Birmingham
Abstract
Background: Anticoagulation using vitamin K antagonists (VKAs) significantly reduces the risk of recurrent stroke in stroke patients with atrial fibrillation (AF) and is recommended by guidelines. Methods: The German Competence NETwork on Atrial Fibrillation established a nationwide prospective registry including 9,574 AF patients, providing the opportunity to analyse AF management according to German healthcare providers. Results: On enrolment, 896 (9.4%) patients reported a prior ischaemic stroke or transient ischaemic attack. Stroke patients were significantly older, more likely to be female, had a higher rate of cardiovascular risk factors, and more frequently received anticoagulation (almost exclusively VKA) than patients without prior stroke history. Following enrolment, 76.4% of all stroke patients without VKA contraindications received anticoagulation, which inversely associated with age (OR 0.95 per year; 95 % CI 0.92-0.97). General practitioners/internists (OR 0.40; 95 % CI 0.21-0.77) and physicians working in regional hospitals (OR 0.47; 95 % CI 0.29-0.77) prescribed anticoagulation for secondary stroke prevention less frequently than physicians working at university hospitals (reference) and office-based cardiologists (OR 1.40; 95 % CI 0.76-2.60). The impact of the treating healthcare provider was less evident in registry patients without prior stroke. Conclusions: In the AFNET registry, anticoagulation for secondary stroke prevention was prescribed in roughly three-quarters of AF patients, a significantly higher rate than in primary prevention. We identified two factors associated with withholding oral anticoagulation in stroke survivors, namely higher age and-most prominently-treatment by a general practitioner/internist or physicians working at regional hospitals.
Details
Originalsprache | Englisch |
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Aufsatznummer | 129 |
Fachzeitschrift | BMC neurology |
Jahrgang | 15 |
Ausgabenummer | 1 |
Publikationsstatus | Veröffentlicht - 5 Aug. 2015 |
Peer-Review-Status | Ja |
Externe IDs
PubMed | 26242880 |
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Schlagworte
ASJC Scopus Sachgebiete
Schlagwörter
- Anticoagulants, Atrial fibrillation, German AFNET registry, Ischaemic stroke, Secondary stroke prevention