RISK OF THROMBOEMBOLISM IN NON-VALVULAR ATRIAL FIBRILLATION AND ADEQUACY OF ANTICOAGULATION IN HIGH RISK PATIENTS

Abstract

Objective: To assess frequency of non-valvular AF, with high risk ofthromboembolism and their adequacy of anticoagulation. Methodology: This study was conducted at National Institute of CardiovascularDisease Karachi from 1st May to 30th September 2017, included patients withnon-valvular AF. Patients were stratified according to thromboembolic risk onCHA DS VASc 2 2 score with more than or equal to 2 as high risk. Information aboutdifferent types of anticoagulant medications was obtained along with recent INRlevel. SPSS 19 was used for the analysis of data and t-test, and Chi-square testswere applied for the assessment and comparison of data. Two sided p≤ 0.05was taken as criteria for statistical significance. Results: A total of 160 patient were studied,52.5% (84) were males, 85.6% (137)found to have CHA DS -VASc score 2 or above. Out of them 62.8% (86) were 2 2taking warfarin and 13.1% (18) were taking Novel oral anticoagulant(NOAC). Outof those at high risk on warfarin only 20.9% (18), were adequatelyanticoagulated. Conclusion: In our study majority of patients with non-valvular AF were at higherrisk of thromboembolism with inadequate anticoagulation. Strategies to improveanticoagulation are needed in this group. Key Words: Atrial fibrillation, Anticoagulation, Thromboembolism,Warfarin, Nonvalvular atrial fibrillation