Nicole Lowres|Katrina Giskes|Charlotte Hespe|Ben Freedman
Reducing Stroke Risk in Atrial Fibrillation: Adherence to Guidelines Has Improved, but Patient Persistence with Anticoagulant Therapy Remains Suboptimal
The Heart Research Institute|University of Sydney|The Heart Research Institute|The University of Notre Dame Australia|The University of Notre Dame Australia|The Heart Research Institute|University of Sydney|Concord Repatriation General Hospital
atrial fibrillation af significant risk factor avoidable stroke among highrisk patients af stroke risk mitigated using oral anticoagulants oacs however reduction largely contingent physician prescription patient persistence oac therapy past decade significant advances occurred revisions clinical practice guidelines relating management stroke risk af several countries introduction nonvitamin k antagonist oacs noacs paper summarises evolving body research examining guidelinebased clinician prescription past decade patientlevel factors associated oac persistence review shows clinicians management past decade increasingly reflected guideline recommendations increasing proportion highrisk patients receiving oacs driven upswing noacs however treatment gap remains 2535 highrisk patients still receive oac treatment great variation countries reduction stroke risk directly relates level oac prescription therapy persistence persistence adherence oac thromboprophylaxis remains ongoing issue 2year persistence low 50 wide variation countries practice settings multiple patientlevel factors contribute poor persistence addition concerns bleeding considered review individual patients factors circumstances assist clinicians implement appropriate strategies address poor persistence review highlights interplay clinicians awareness guideline recommendations understanding individual patientlevel factors impact adherence persistence required reduce incidence preventable stroke attributable af