|
Antithrombotic treatment of atrial fibrillation
in a regional hospital in Hong Kong
CS Leung, KM Tam
Department of Medicine, Yan Chai Hospital, Tsuen Wan, Hong Kong
OBJECTIVE. To measure the use, appropriateness,
and safety of antithrombotic therapy in Hong Kong Chinese patients
with atrial fibrillation.
DESIGN. Retrospective review.
SETTING. Regional hospital, Hong Kong.
SUBJECTS AND METHODS. Medical records of all patients
with atrial fibrillation admitted to acute internal medicine wards
in April 2000 and between July and October 2001 were reviewed for
details of antithrombotics given, results
of international normalised ratio monitoring for patients receiving
warfarin, side-effects, and additional risk factors for complications
of atrial fibrillation. Statistical analysis was undertaken to assess
factors predictive of antithrombotic
use.
RESULTS. A total of 207 patients with chronic atrial
fibrillation were included in the study. Of these, 44.0% of patients
with non-valvular atrial fibrillation without contra-indications
for warfarin use were receiving warfarin, 34.1%
were receiving aspirin, and 22.0% were receiving no antithrombotic
therapy. The majority of patients (69.1%) were treated appropriately
according to the American College of Chest Physicians guidelines.
The major side-effect rates
for warfarin and aspirin were 2.14% and 1.72% per patient-year,
respectively, which were comparable with western studies of usual
clinical practice. The ischaemic stroke rate for patients taking
warfarin or aspirin were 1.40% and
6.02% per patient-year, respectively. The median international normalised
ratio was 1.96. The median frequency of international normalised
ratio measurement was 45.58 days.
CONCLUSIONS. This study found that antithrombotic
use in a Hong Kong regional hospital for patients with atrial fibrillation
was similar to that reported from western institutions. Complication
and stroke rates were also comparable to
the western data relating to usual clinical practice.
Hong Kong Med J 2003;9:179-85
Key words: Anticoagulants; Aspirin; Atrial fibrillation;
Chinese; Warfarin
|
