Many Patients Newly Diagnosed with Atrial Fibrillation Are Not Prescribed Anticoagulants

A recent study highlights a concerning trend in the management of patients newly diagnosed with atrial fibrillation (AF) during hospitalization. Despite the established benefit of anticoagulants in reducing stroke risk in AF patients, most individuals do not receive these medications within the first year after discharge. The study, published online on April 22, 2025, in the Annals of Internal Medicine, analyzed a large population-based cohort of patients aged 66 and older who were hospitalized between April 2013 and March 2023 with a new diagnosis of AF for various primary reasons, including both cardiac and non-cardiac conditions.

The researchers found that among over 20,000 patients diagnosed with AF, only about 26.4% of those with moderate stroke risk scores (CHA2DS2-VASc scores of 1 to 4) and 35.2% of those with higher scores (5 to 8) were prescribed anticoagulants within a year. Notably, the one-year stroke risk without anticoagulation was relatively low, at around 1.0% to 1.3% across different patient groups. However, the risk for stroke in patients with higher CHA2DS2-VASc scores, particularly those with scores above 4, can significantly exceed these percentages, emphasizing the importance of appropriate anticoagulation therapy.

The findings suggest that many eligible patients are not receiving potentially lifesaving anticoagulation treatment, especially those with higher predicted risks of stroke. The authors call for further research to address this gap and improve adherence to clinical guidelines, particularly in patient groups with elevated stroke risks following a hospital-based AF diagnosis. This issue underscores the need for better clinical decision-making and follow-up strategies to prevent avoidable strokes in this vulnerable population.

Source: https://medicalxpress.com/news/2025-04-patients-newly-atrial-fibrillation-anticoagulants.html