Most patients newly diagnosed with atrial fibrillation do not receive anticoagulants

For patients newly diagnosed with atrial fibrillation (AF) during hospitalization for other causes, most are not dispensed anticoagulants in the year after discharge, although some have a stroke risk approximating the threshold for initiation, according to a study published online April 22 in the Annals of Internal Medicine . Husam Abdel-Qadir, M.D.

, Ph.D., from the University of Toronto, and colleagues conducted a population-based retrospective cohort study involving patients aged 66 years or older discharged alive from the hospital between April 2013 and March 2023 with a first diagnosis of AF to describe their risk for stroke.



The researchers found that AF was diagnosed in 20,639 patients while hospitalized for other causes: 40.4%, 34.4%, 17.

2%, and 8.0% for noncardiac medical, cardiac surgical, noncardiac surgical, and cardiac medical diagnoses, respectively. Anticoagulants were being dispensed to 26.

4% and 35.2% of patients with CHA 2 DS 2 -VA scores of 1 to 4 and 5 to 8, respectively, at one year. The one-year risk for stroke without anticoagulation was 1.

3%, 1.2%, 1.1%, and 1.

0% for cardiac medical, noncardiac medical, noncardiac surgical, and cardiac surgical patients, respectively. The one-year stroke risk was 0.7% and 1.

8% without anticoagulation for patients with CHA 2 DS 2 -VA scores of 1 to 4 and 5 to 8, respectively. "The risk for stroke in patients with higher CHA 2 DS 2 -VA scores and those hospitalized with cardiac medical diagnoses may exceed the recommended thresholds for anticoagulation for stroke prophylaxis, raising the need for future research focused on those patient groups," the authors write. More information: Husam Abdel-Qadir et al, Risk for Stroke After Newly Diagnosed Atrial Fibrillation During Hospitalization for Other Primary Diagnoses, Annals of Internal Medicine (2025).

DOI: 10.7326/ANNALS-24-01967 Nimesh S. Patel et al, A New Perspective on Atrial Fibrillation "Provoked" by Hospitalization, Annals of Internal Medicine (2025).

DOI: 10.7326/ANNALS-25-01073 © 2025 HealthDay . All rights reserved.

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