Use of Oral Anticoagulants in Patients with Atrial Fibrillation in Turkey

The aim of the study was to investigate the warfarin and aspirin usage patterns of physicians in patients with atrial fibrillation. Accordingly, questionaries were sent to 438 cardiologists and internists and their indications for the use of warfarin and aspirin in patients with atrial fibrillation was asked. 366 questionaires were received back from 113 (30.9%) cardiologists and 253(69.1%) internists. In patients with rheumatic heart disease and chronic atrial fibrillation, the rate of regular and conditional warfarin prescription was reported to be 38.1% and 39.8%, respectively for cardiologists, whereas these rates were 27.3% and 52.2% for internists, respectively. The rate of regular use of warfarin was found to be significantly higher in cardiologists than internists (p=0.00005). The rate of regular use of warfarin in patients with non-valvular atrial fibrillation and chronic atrial fibrillation was reported to be significantly higher among cardiologists (23%) than internists (4.7%) (p< 0.0001). Likewise, regular warfarin utilization was reported more frequent in patients with intermittant atrial fibrillation and rheumatic heart disease among cardiologists than internists (27.4% versus 22.1%) (p< 0.05), whereas no difference was found between cardiologists and internists regarding warfarin prescription in patients with intermittent atrial fibrillation and rheumatic heart disease (27.4% versus 22.1%, respectively). For patients with chronic atrial fibrillation and valvular or non-valvular heart disease regular aspirin prescription was reported to be 77.9% and 83.2%, for cardiologists and 87.4% and 97.2% for internists, respectively. In conclusion, warfarin has been reported to be underutilized in patients with atrial fibrillation, and cardiologists have reported significantly higher usage rates for warfarin in this regard.