Mitral Stenosis Associated Atrial Fibrillation and Use of Anticoagulation

Abstract

Objective: To determine the anticoagulation practice in local population suffering of mitral stenosis and atrial fibrillation that are actually high risk for thrombo embolism and are in fact candidates for anticoagulation

Study Design: Descriptive / cross sectional study

Place and Duration of Study: This study was conducted at Cardiovascular Department Lady Reading Hospital Peshawar from 1.12.2014 to 30.10. 2015.

Materials and Methods: Study comprised 100 patients with atrial fibrillation (AF) and mitral stenosis were studied. All patients visiting OPD with EKG evidence of atrial fibrillation and echocardiography evidence of mitral stenosis were included.

Results: Mean age was 59.7±13.7 years. Male were 39% (n=39). Only 25% (n=25) patients were adequately treated with anticoagulant therapy using warfarin. Most of the patients (34%) were on dual antiplatelet therapy. Factors associated with underutilization of anticoagulant therapy were, patient preference 40%, older age of 65 and above 15%, monitoring issue 23%, affordability 7% and prior complications due to anticoagulation therapy in 15%.

Conclusion: Atrial fibrillation is still an undertreated condition and most patients with AF and mitral stenosis are still deprived of benefits of anticoagulant therapy. Majority of these high risk patients are treated with antiplatelet therapy.