Atrial fibrillation still not treated adequately

During the “Asia-Pacific Cardiology Forum” along the World Congress of Cardiology on June 18,2010, Prof. Marcel Levi, MD, PhD, informed journalists at a round table discussion that the prevalence and incidence atrial fibrillation will significantly increase due to the ageing population.

In Europe alone, it is estimated that more than 4 million people suffer from atrial fibrillation. Main complication of atrial fibrillation is stroke. On one hand, so M. Levi, stroke is a high burden on families, on the other hand, strokes cause significant costs to health care system globally.

Treatment of atrial fibrillation is still not optimal. The reason is that some physicians are still reluctant to prescribe anticoagulants, which are available for more than 50 years, because they are concerned about potential major bleedings. Minimization of bleeding risks is feasible with regular and frequent INR monitoring.

Only about 30% of all patients suffering from atrial fibrillation are treated with anticoagulants globally, while an estimated 60-70 % would require this treatment. If those patients were treated adequately, the stroke could be lowered by two thirds.

M. Levi referred to a recently published consensus paper, which was developed by a group of renowned thought leaders. One conclusion from this publication is that benefits of anticoagulation treatment with frequent INR monitoring outweigh the rate of major bleedings.

"The higher the involvement of patients into anticoagulation management, the lower the rate of thrombotic events or major bleeds", so M. Levi.

In many countries, INR values are typically measured every 4 to 8 weeks at the GP’s office and /or the lab. More frequent testing could lead to increased efforts for patients. One opinion could be – similar to hypertension: I as patient do not feel high or low INR values, so I rely on my physicians.

We, the patients who have decided to get engaged, we know about the potential risks and therefore test our INR every week. Wherever we are, with the INR meters designed for patient self testing.

Christian Schaefer, September, 2010