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Aspirin still overprescribed for stroke prevention in AF
Date:1/28/2014

ing of antithrombotic treatment, which includes oral anticoagulation therapy (warfarin and the novel oral anticoagulants) and antiplatelet drugs (mainly aspirin).4 The data are from the EORP Atrial Fibrillation General Pilot Registry of more than 3 100 patients in nine countries.5

Overall the study found that the use of oral anticoagulants has improved over the last decade since the last Euro Heart Survey was performed. Where oral anticoagulation was used, most patients (72%) were prescribed warfarin and just 8% were prescribed a new oral anticoagulant.

Professor Lip said: "Novel oral anticoagulant uptake is still a bit low, probably because of differences in regulatory approval, costs and access to drugs in different countries. But the main point is that overall oral anticoagulant uptake as a whole has improved in the last 10 years."

Aspirin was commonly prescribed, either alone or in combination with an oral anticoagulant, when patients had myocardial infarction or coronary artery disease. The strongest reason to prescribe both drugs was coronary artery disease, which increased the use of combined therapy by more than eight-fold.

Professor Lip said: "Aspirin is still overused for stroke prevention in AF. ESC guidelines say concomitant aspirin should not be given to anticoagulated AF patients with stable vascular disease. The combination of drugs does not reduce cardiovascular events and stroke but does increase the risk of bleeding."

Another worrying finding was that oral anticoagulants were underprescribed in elderly patients, with aspirin alone more commonly prescribed. Professor Lip said: "Elderly patients are at the highest risk for stroke and yet they are given aspirin which is not recommended and potentially harmful. There is a perception that elderly patients do not do well on anticoagulation. But a number of studies now, including BAFTA,6 have shown that in elderly patients warfarin is far superior to aspirin in
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Contact: ESC Press Office
press@escardio.org
33-049-294-7756
European Society of Cardiology
Source:Eurekalert

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