Quality of Care for Atrial Fibrillation Among Patients Hospitalized for Heart Failure
Jonathan P. Piccini, MD*,
Adrian F. Hernandez, MD, MHS*,*,
Xin Zhao, PhD*,
Manesh R. Patel, MD*,
William R. Lewis, MD ,
Eric D. Peterson, MD, MPH*,
Gregg C. Fonarow, MD Get With The Guidelines Steering Committee and Hospitals
* Duke Clinical Research Institute, Durham, North Carolina
MetroHealth Campus, Case Western Reserve University, Cleveland, Ohio
University of California Los Angeles Medical Center, Los Angeles, California
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Figure 1 Warfarin Use at Discharge Among Eligible Heart Failure Patients According to the CHADS2 Score
Among eligible heart failure patients with atrial fibrillation (n = 15,748), warfarin use declined with increasing risk for stroke, as indexed by higher CHADS2 (congestive heart failure, hypertension, age >75, diabetes, and prior stroke or transient ischemic attack) scores (p for trend <0.0001).
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Figure 3 Warfarin Use at Discharge Across Time
Among eligible heart failure patients with atrial fibrillation, there was no evidence of increasing use of warfarin at discharge with time, in either quarterly (p = 0.126) or yearly (p = 0.146) assessments.
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Figure 4 Antithrombotic Therapy at Discharge
Shown here is the prevalence of each antithrombotic regiment prescribed at discharge among eligible patients with heart failure and atrial fibrillation. Eighty-nine percent of the cohort was taking at least some form of antithrombotic therapy (either warfarin or an antiplatelet agent).
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