The use status of anticoagulation drugs for inpatients with nonvalvular atrial fibrillation in Southwest China

Background: Oral anticoagulants (OACs) are effective for the prophylaxis of stroke in patients with atrial fibrillation (AF). This cross-sectional study aimed to investigate the status of anticoagulation treatment for hospitalized AF patients in Southwest China. Methods: A total of 4760 hospitalized patients with AF were enrolled from 21 hospitals in Chongqing city from January 1 to December 31, 2013. Results: Among the enrolled patients, 3785 were diagnosed with nonvalvular AF. These patients had a mean age of 74.4 +/- 10.1 years. The mean CHADS(2) score of all subjects was 2.60 +/- 1.34, and 80.7% of the patients had CHADS(2) >= 2. The use rate of OACs was only 11.5% for patients with a high risk for stroke (CHADS(2) >= 2) and was much lower in patients from the second-level hospitals than in patients from the third-level hospitals (5.8% vs. 16.9%, P<0.001). The leading reason for the underuse of OACs in high-risk patients was physician's nonfeasance. Conclusion: This study demonstrated that the underuse of anticoagulation therapy in hospitalized patients with nonvalvular AF was particularly serious in Southwest China, especially in the second-level hospitals. Urgent and effective measures are desperately needed to improve this alarming situation in China.