THE USE OF ORAL ANTICOAGULANTS IN THE TREATMENT OF ATRIAL FIBRILLATION AT LONG KHANH REGIONAL GENERAL HOSPITAL

Abstract

Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia that substantially increases the risk of stroke and thromboembolism, in which oral anticoagulants play a pivotal role in event prevention.

Objective: Assessment of anticoagulant use, treatment appropriateness, anticoagulant-related adverse events, and 3-month clinical outcomes in patients with AF.

Methods: A descriptive cross-sectional study was conducted in patients with AF between July 1, 2023, and June 30, 2024 at the Cardiology–Geriatrics Department of Long Khanh Regional General Hospital. Thromboembolic risk was assessed using the CHA2DS2-VASc score. Appropriateness of anticoagulant therapy (indication and dosage) was evaluated by the recommendations of the Vietnam National Heart Association in 2022.

Results: A total of 401 patients were included, with 58.6% being female and a median age of 73 years (64–84). According to the CHA₂DS₂-VASc score, 90.5% of patients were classified as having a high risk of thromboembolism. Anticoagulant therapy was indicated in 87.3% of cases, with rivaroxaban and acenocoumarol accounting for 66.8% and 32.4% of prescriptions, respectively. The overall rate of appropriate anticoagulant use was 47.4%. Among patients receiving anticoagulant therapy, gastrointestinal bleeding occurred in 12/350 cases (3.4%). During the 3-month follow-up after discharge, 289/401 patients (72.1%) attended follow-up visits, and 14 thromboembolic events were documented.

Conclusion: Appropriate anticoagulant dosing regimens in accordance with treatment guidelines are necessary, particularly in older adult patients and those with impaired renal function.

Keywords: atrial fibrillation; oral anticoagulants; CHA2DS2-VASc; HAS-BLED