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Title: Rate and reasons for the use of oral anticoagulants in patients with non-valvular atrial fibrillation and a CHA<inf>2</inf>DS<inf>2</inf>-VASc score of 0 in Thailand: The COOL-AF registry
Authors: Komsing Methavigul
Arjbordin Winijkul
Sirin Apiyasawat
Ratikorn Methavigul
Thanasak Patmuk
Pattraporn Srirattana
Praprut Thanakitcharu
Kulyot Jongpiputvanich
Sumon Tangsuntornwiwat
Ahthit Yindeengam
Rungroj Krittayaphong
Tomorn Thongsri
Kriengkrai Hengrussamee
Wattana Wongtheptien
Pornchai Ngamjanyaporn
Arintaya Phrommintikul
Smonporn Boonyaratavej
Pongpun Jittham
Treechada Wisaratapong
Rungroj Krittayaphong
Roj Rojjarekampai
Somchai Dutsadeevettakul
Chaiyasith Wongvipaporn
Thanita Boonyapiphat
Weerapan Wiwatworapan
Khanchai Siriwattana
Thoranis Chantrarat
Kasem Ratanasumawong
Wiwat Kanjanarutjawiwat
Suchart Arunsiriwattana
Udon Thani Center Hospital
Nakornping Hospital
Lampang Hospital
Chonburi Regional Hospital
Prapokklao Hospital
Chulalongkorn University
Police General Hospital
Naresuan University
Vajira Hospital
Khon Kaen University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Mahidol University
Thammasat University
Buddhachinaraj Hospital
Faculty of Medicine, Siriraj Hospital, Mahidol University
Phramongkutklao College of Medicine
Prince of Songkla University
Chiang Mai University
Ratchaburi Regional Hospital
Golden Jubilee Medical Center
Charoenkrungpracharak Hospital
Sapphasitthiprasong Hospital
Surat Thani Hospital
Central Chest Institute of Thailand
Maharat Nakorn Ratchasima Hospital
Chiangrai Prachanukroh Hospital
Keywords: Medicine
Issue Date: 1-Oct-2020
Citation: Journal of the Medical Association of Thailand. Vol.103, No.10 (2020), 987-995
Abstract: © JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2020. Background: A substantial number of patients with non-valvular atrial fibrillation (NVAF) and a CHA2DS2-VASc score of 0 (i.e., low-risk group) use oral anticoagulants (OACs). Objective: To investigate the rate and reasons for OAC use in Thai patients with NVAF and having a CHA2DS2-VASc score of 0. Materials and Methods: A nationwide observational multicenter registry of patients with NVAF was set up in Thailand. The patients’ demographic and clinical data were recorded on a case record form and then entered into a web-based data collection and management system. Results: One hundred seventy-six patients with NVAF and a CHA2DS2-VASc score of 0 were included. The average age was 53.9±8.2 years old, and all patients were male. Forty-six (26.1%) of the patients received OACs. NVAF patients receiving OACs had a longer duration of AF, more persistent and permanent AF, and mild left ventricular dysfunction. NVAF patients not receiving OACs were significantly more likely to be taking antiplatelet drugs. The reasons for using OACs in patients with a CHA2DS2-VASc score of 0 included thrombus in the left atrial appendage, post-AF ablation, planned cardioversion, hypertrophic cardiomyopathy, hyperthyroidism, and endomyocardial fibrosis. Physicians or patients preferred OAC use despite having a CHA2DS2-VASc score of 0 in 24 patients (52.2%). The use of OACs did not decrease clinical events, but it increased the bleeding risk. Conclusion: Among Thai NVAF patients with CHA2DS2-VASc score of 0, OAC was used in 26.1%. Some stroke risk factors were identified but were not included in the current risk scoring tool.
ISSN: 01252208
Appears in Collections:Scopus 2020

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