NON-ANTICOAGULATION IN ATRIAL-FIBRILLATION

Atrial fibrillation (AF) is an important risk factor for stroke and an ticoagulation is now indicated in many patients at increased risk. Stu dies however have shown that many patients at risk are not anticoagula ted for reasons that are not well explored. We identified prospectivel y the reasons for non-anticoagulation in patients with AF in 94 consec utive hospital patients with cardiac or cerebrovascular disease who ha d AF. Patients with intermittent or lone AF and < 60 years were exclud ed n = 16. The remaining group had a mean age of 76 +/- 7 years with a mental test score of 7.4 +/- 2 (normal 10), 31 lived alone and they l ived an average of 14 +/- 11 miles from the hospital laboratory. The r easons for non-anticoagulation overlapped and were: medical in 29: cog nitive impairment/compliance in 32: and monitoring problems in 50. Ant icoagulation for AF in the elderly is a complex enterprise which must take into account social and cognitive as well as medical issues.