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Year : 2019  |  Volume : 10  |  Issue : 1  |  Page : 85

Optimal choice of pharmacological therapy – Prevention of stroke and assessment of bleeding risk in patients with atrial fibrillation

1 Clinic for Heart, Blood Vessel and Rheumatic Diseases, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Department of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology; Department of Cardiology, General Hospital "Prim.dr.Abdulah Nakas", Sarajevo, Bosnia and Herzegovina
3 Zentrum für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, SLK Kliniken Heilbronn, Heilbronn, Germany
4 Department of Pediatric Cardiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
5 Department of Science Editing, Academy of Medical Sciences in Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina

Correspondence Address:
Izet Masic
Department of Science Editing, Academy of Medical Sciences in Bosnia and Herzegovina, Sarajevo
Bosnia and Herzegovina
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpvm.IJPVM_426_18

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Background: The aim of the study was to highlight the importance of adequate anticoagulant therapy and the correlation of higher risk of stroke. Methods: This study analyzed data obtained from 103 patients with diagnosis of atrial fibrillation (AF) (39 of them had a stroke). Patients were divided into groups according to the CHADS2, CHA2DS2-VASc, and HASBLED scores. Results: An analysis showed that anticoagulant drugs were more often prescribed to subjects <75 years of age (P = 0.001). Patients with a higher CHADS2 score had a higher CHA2DS2-VASc score and vice versa (rho = 0.513; P = 0.0001). According to the CHA2DS2-VASc, 91.3% of the patients examined were prescribed an anticoagulant medication as a therapy at discharge from the hospital. The result was statistically significant compared to the practice where an anticoagulant was prescribed to 55.9% of high-risk subjects as estimated by the CHA2DS2-VASc score (P < 0.05). Our results also show that rivaroxaban is more commonly prescribed as a discharge therapy than warfarin (χ2 = 12.401; P = 0.0001). Furthermore, a significantly higher number of patients who were being prescribed aspirin (38.5%) had a stroke compared to 12.8% of patients who were being prescribed warfarin (χ2 = 12.259; P = 0.0001). Conclusions: Novel oral anticoagulants (NOACs) seem to be a better choice as a pharmacological therapy in the treatment of AF, due to a lack of adequate monitoring of patients' international normalized ratio (INR) values. CHA2DS2-VASc and HASBLED scores must be used as a part of routine clinical diagnostics when dealing with patients with AF.

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