Background: Anticoagulants can reduce thromboembolic events in patients with non-valvular atrial fibrillation (AF). The underuse of anticoagulant may be related to history of major bleeding.

Objective: To compare the rate of anticoagulant use in non-valvular AF patients with and without a history of major bleeding.

Materials and Methods: The present study was a prospective study of non-valvular AF patients at the cardiology outpatient department of Siriraj Hospital between June 2014 and September 2016. The following data were collected, patient age, gender, underlying disease, risk score, consisting of CHADS₂, CHA₂DS₂-VASc, and HAS-BLED, history of bleeding and severity, and type of antithrombotic drugs. The rates of anticoagulant use were compared between patients with and without a history of major bleeding.

Results: The authors enrolled 424 non-valvular AF patients, of which 58.7% were male. The mean age was 70.5±10.5 years old. The mean CHA₂DS₂-VASc and HAS-BLED scores were 3.55±1.76 and 1.88±1.05, respectively. Overall, 334 patients (78.8%) received anticoagulants, 75 patients (17.7%) received antiplatelets without an anticoagulant, and 15 patients (3.5%) did not receive any antithrombotic drugs. Of the 424 non-valvular AF patients, 97 patients (22.9%) had a history of bleeding, of which 37 patients (8.7%) had major bleeding. Anticoagulants were used in 67.6% of patients with a history of major bleeding and 79.9% of patients without a history of major bleeding (p=0.08). Patients with a history of major bleeding used warfarin less than those without a history of major bleeding (62.2% versus 77.3%, p=0.040).

Conclusion: Rate of anticoagulant use was 78.7% in patients with non-valvular AF. Patients with a history of major bleeding tended to use warfarin less than those without a history of major bleeding.

Keywords: Atrial fibrillation, Major bleeding, Anticoagulants

Received 26 Feb 2020 | Revised 12 Mar 2020 | Accepted 16 Mar 2020