Ann Intern Med

Many patients with newly diagnosed afib don’t receive anticoagulants

April 25, 2025

Study details: This population-based retrospective cohort study analyzed data from patients aged ≥66 years in Ontario, Canada, who were discharged alive from the hospital between April 2013 and March 2023 with a first diagnosis of afib. The study categorized afib diagnoses into cardiac medical, noncardiac medical, cardiac surgical, and noncardiac surgical.

Results: Afib was diagnosed in 20,639 patients (mean age 77 years; 58% male) during hospitalization for other causes. One year later, 26.4% of patients with CHA₂DS₂-VA scores of 1 to 4 and 35.2% of those with scores of 5 to 8 were receiving anticoagulants. Patients with CHA₂DS₂-VA scores of 1 to 4 had a one-year stroke risk of 0.7% (CI, 0.6% - 1.0%), compared with 1.8% (CI, 1.4% to 2.2%) for scores of 5 to 8. The one-year stroke risk without anticoagulation was 1.3% for cardiac medical, 1.2% for noncardiac medical, 1.1% for noncardiac surgical, and 1.0% for cardiac surgical patients.

Clinical impact: Consider initiating anticoagulation therapy and closely monitoring these patients to reduce the risk of stroke. Implementing proactive measures could significantly improve patient outcomes and prevent stroke-related complications.

Source:

Abdel-Qadir H, et al. (2025, April 22). Ann Intern Med. Risk for Stroke After Newly Diagnosed Atrial Fibrillation During Hospitalization for Other Primary Diagnoses : A Retrospective Cohort Study. https://pubmed.ncbi.nlm.nih.gov/40258280/