The new results suggest that AF patients may be a perfect population to target for preventive messages in the ER. The study is the first to document an elevated rate of AF among ER visitors -- 1.1 percent of all ER patients, as opposed to the estimated 0.89 percent of the total American population.
And, the findings show that many people with atrial fibrillation are still getting no treatment or sub-optimal treatment to prevent clots and stave off a stroke.
A blood thinning drug called warfarin, often sold as Coumadin, is the gold-standard stroke prevention drug for most patients with AF. Some who cannot take warfarin because of other conditions are given a prescription for anti-platelet drugs or aspirin. But the new study, like other recent studies, shows that only about half of AF patients eligible for warfarin therapy are taking it.
"Current computer models estimate that we could prevent 40,000 strokes each year if we were able to get all eligible patients on appropriate medication," says Scott. That number is based on data showing that anticoagulation therapy in AF patients decreases the risk of strokes caused by clots by 68 percent, while only increasing strokes caused by bleeding by 0.3 percent.
Even as warfarin use lags, emergency room visits are climbing. More than 30 percent of all ER visits are made by people over 45 years of age, the key at-risk population for AF. And AF is the most common heart rhythm disorder seen in ER patients; AF patients are likely to visit the ER for chest pain, shortness of breath and heart palpitations. In addition, the ER is an important source of health care for people without health insurance or a regular health care provider.