Hong Kong Med J 2003;9:179-85 | Number 3, June 2003
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.
Key words: Anticoagulants; Aspirin; Atrial fibrillation; Chinese; Warfarin
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