Most Patients Newly Diagnosed With A-Fib Do Not Receive Anticoagulants

WEDNESDAY, April 23, 2025 (HealthDay News) — For patients newly diagnosed with atrial fibrillation (AF) during hospitalization for other causes, most are not dispensed anticoagulants in the year after discharge, although some have a stroke risk approximating the threshold for initiation, according to a study published online April 22 in the Annals of Internal Medicine.

Husam Abdel-Qadir, M.D., Ph.D., from the University of Toronto, and colleagues conducted a population-based retrospective cohort study involving patients aged 66 years or older discharged alive from the hospital between April 2013 and March 2023 with a first diagnosis of AF to describe their risk for stroke.

The researchers found that AF was diagnosed in 20,639 patients while hospitalized for other causes: 40.4, 34.4, 17.2, and 8.0 percent for noncardiac medical, cardiac surgical, noncardiac surgical, and cardiac medical diagnoses, respectively. Anticoagulants were being dispensed to 26.4 and 35.2 percent of patients with CHA₂DS₂-VA scores of 1 to 4 and 5 to 8, respectively, at one year. The one-year risk for stroke without anticoagulation was 1.3, 1.2, 1.1, and 1.0 percent for cardiac medical, noncardiac medical, noncardiac surgical, and cardiac surgical patients, respectively. The one-year stroke risk was 0.7 and 1.8 percent without anticoagulation for patients with CHA₂DS₂-VA scores of 1 to 4 and 5 to 8, respectively.

“The risk for stroke in patients with higher CHA₂DS₂-VA scores and those hospitalized with cardiac medical diagnoses may exceed the recommended thresholds for anticoagulation for stroke prophylaxis, raising the need for future research focused on those patient groups,” the authors write.

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