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Anticoagulation Both Over- and Under-Prescribed in A-Fib

May be unnecessary for those at low risk of stroke

WEDNESDAY, April 15, 2015 (HealthDay News) -- As many as one-quarter of people with atrial fibrillation who have a low risk of stroke are prescribed anticoagulation unnecessarily, a new study contends. The findings were published in a research letter online April 13 in JAMA Internal Medicine.

Gregory Marcus, M.D., of the University of California, San Francisco (UCSF), and colleagues collected information from 10,995 atrial fibrillation patients across the United States, all younger than 60. The patients were also all considered to have a low risk of stroke. Still, the researchers found that about 25 percent of them were prescribed oral anticoagulant therapy, contrary to current treatment guidelines.

Men were more likely to be prescribed anticoagulant therapy than women, as were older patients and overweight patients without stroke risk factors. The findings show that doctors may not be fully aware of the potential risks of these drugs, or the particularly low risk of stroke in certain atrial fibrillation patients, the researchers said.

"The irony is that there is a general push to get providers to prescribe these drugs, and they are also generally under-prescribed among many atrial fibrillation patients who actually need them," Marcus noted in a UCSF news release. "Our study suggests people are trying to do the right thing, but due to a lack of understanding of some of the critical nuances, go too far in that direction in low-risk patients."

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