Many Patients Unaware of Stroke, Bleeding Risk in Atrial Fibrillation

HealthDay News — Many Canadian patients are unaware of stroke and bleeding risks associated with atrial fibrillation, according to a study published in the Canadian Journal of Cardiology.

Paul Angaran, MD, from the University of Toronto, and colleagues collected data on 4,670 atrial fibrillation patients aged 18 years and older without significant valvular heart disease. Participants were chosen from the primary care practices of 474 physicians as part of the Canadian Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation chart audit.

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The researchers found that in 15 and 25% of patients, respectively, physicians did not provide an estimate of stroke and bleeding risk. When risks were provided, they were on the basis of a predictive stroke and bleeding risk index for only 50 and 26%, respectively. In a large proportion of patients, there was overestimation and underestimation of stroke and bleeding risk. Antithrombotic therapy included warfarin (90%); 24% of patients had a time in the therapeutic range (TTR) < 50%, 9% between 50% and 60%, 11% between 60% and 70%, and 56% had a TTR ≥ 70%.

“These findings suggest an opportunity to enhance knowledge translation to primary care physicians,” the authors write.

One author was employed by LinCorp Medical.


  1. Angaran P et al. Can J Cardiol. 2015;doi:10.1016/j.cjca.2015.07.012.