ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 234
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Time trends in stroke risk management among patients with
atrial fibrillation in Australia between 2011 and 2019
Dr Katrina Giskes1,2, Nicole Lowres2,3, Jessica Orchard4, Professor Charlotte Hespe1, Karice Hyun5
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University of Notre Dame Australia, 2Heart Research Institute, 3Charles Perkins Centre, The University
of Sydney, 4Centenary Institute, The University of Sydney, 2School of Health Sciences, The University of
Sydney
Background
Atrial fibrillation (AF) is associated with increased stroke risk. Changes to management
recommendations in 2016 advised that anticoagulation be prioritised above bleeding risk among highrisk patients and that antiplatelet agents (APAs) are not effective for reducing stroke risk.
Purpose
To examine trends in stroke risk management among patients with AF and high stroke risk between
2011 and 2019.
Methods
Deidentified data of patients in 164 Australian general practices between 2011 and 2019. Stroke risk
was calculated by the CHA2DS2-VA score (score ≥2 = ‘high risk’). Patients were identified as being
managed by oral anticoagulants (OACs; ie warfarin or non-vitamin K oral anticoagulants [NOACs]),
APAs only or neither. Characteristics of those receiving guideline-recommended management
between 2011 and 2015 were compared to those between 2016 and 2019.
Results
Data were available for 340,463 patients, 8696 (2.6%) had AF; 84.8% (n = 7034) had high stroke
risk. Those managed on OACs increased from 56.7% in 2011 to 73.7% in 2019, while the proportion
prescribed APAs only mirrored the OAC curve and declined from 31.1% to 14.0%. Patients receiving
neither remained steady (around 12%). Males, older patients and those with comorbidities were more
likely to receive the recommended treatment in 2016–19 compared to 2011–15.
Conclusions
The improvements in stroke risk management among patients with AF over the past decade with
increased OAC use (mostly NOACs) and reductions in patients receiving APAs will likely reduce AFrelated strokes. Further declines in strokes could be achieved by targeting patients not receiving any
antithrombotic therapy and those inappropriately managed with APAs only.
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