The One-Year Outcome of Patients with Non-valvular Atrial Fibrillation According to the Nature and Quality of the Antithrombotic Treatment Administered on an Outpatient Basis

Abstract

Background: Prior studies have shown a treatment gap in oral anticoagulant (OAC) use among patients with atrial fibrillation. It has been also shown that the lack of correct anticoagulation leads to greater risks of thromboembolic complications Methods: Using data collected beetween 2016 and 2017 we analysed the outcome of NVAF patients according to the nature and the quality of the antithrombotic treatment preccribed on an outpatients basis. Results: The mea nage of patients was 61.8 years with a male predominance of 52.7%. Dilated cardiomyopathies were the most prevalente underlying cardiopathies. The thromboembolic ris was high with a mean CHA2DS2VASC Score of 3. The hemorragic risk was low according to the HASBLED mean score of 0.8. Among 186 outpatients identified in our registry 135 received oral anticoagulant mainly VKA (132/135:97.8%), 28 received aspirin while 23 received no antithrombotic treatment. The one-year analysis revealed that patients well anticoagulated (TTR ≥65%) had the less mortality prevalence while those with TTR<65%, treated with aspirin or receving no antithrombotic treatment presented the highest mortality rate (p=0.018). Conclusion: Our work confirms the suboptimal use of oral anticoagualnt therapy in the management of NVAF and the necessity of a good oral anticoagulation therapy in the management of NVAF even in black patients thought to have lesser risk of thromboembolic complications.