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Many Doctors Don't Explain Stroke, Bleeding Risk in A-Fib

In substantial proportion of patients, primary care physicians did not provide stroke or bleeding risk

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WEDNESDAY, Oct. 21, 2015 (HealthDay News) -- For many Canadian patients with atrial fibrillation, primary care physicians do not provide stroke or bleeding risk estimates, according to a study published online Oct. 14 in the Canadian Journal of Cardiology.

Paul Angaran, M.D., from the University of Toronto, and colleagues collected data on 4,670 atrial fibrillation patients aged 18 years and older without significant valvular heart disease. Participants were chosen from the primary care practices of 474 physicians as part of the Canadian Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation chart audit.

The researchers found that in 15 and 25 percent of patients, respectively, physicians did not provide an estimate of stroke and bleeding risk. When risks were provided, in only 50 and 26 percent of patients were they on the basis of a predictive stroke and bleeding risk index, respectively. In a large proportion of patients there was overestimation and underestimation of stroke and bleeding risk. Antithrombotic therapy included warfarin (90 percent); overall, 24, 9, 11, and 56 percent of patients had a time of less than 50 percent, 50 to 60 percent, 60 to 70 percent, and more than 70 percent in the therapeutic range, respectively.

"These findings suggest an opportunity to enhance knowledge translation to primary care physicians," the authors write.

One author was employed by LinCorp Medical.

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