Prevalence of Inappropriate Use of Digoxin in 136 Patients on Digoxin and Prevalence of Use of Warfarin or Aspirin in 89 Patients With Persistent or Paroxysmal Atrial Fibrillation

Abstract

Of 136 patients, mean age 72 years, receiving digoxin in the hospital or in the medical clinic, 47 (35%) had heart failure with reduced left ventricular ejection fraction and symptoms despite optimal medical therapy, 82 (60%) had persistent atrial fibrillation (AF), and 7 (5%) had paroxysmal AF. The prevalence of inappropriate use of digoxin was 5%. Of 89 patients with persistent or paroxysmal AF, 70 (79%) were being treated with warfarin to maintain an International Normalized Ratio between 2.0 and 3.0, 15 (17%) were being treated with aspirin 325 mg daily, and 4 (4%) were not being treated with warfarin or aspirin. The prevalence of nonuse of warfarin or aspirin in patients with persistent or paroxysmal AF was 4%.

Effect of Frailty and Age on Platelet Aggregation and Response to Aspirin in Older Patients with Atrial Fibrillation: A Pilot Study

“…According to the current guidelines, aspirin is not recommended for stroke prevention in AF unless patients refuse the use of any oral anticoagulant [ 9 , 10 ]. International drug utilization studies show that, in practice, 17–45% of older adults use aspirin for stroke prevention in AF [ 11 – 14 ]. The evidence for stroke prevention in AF with aspirin is weak and the risk of major bleeding with aspirin is not significantly different to that of oral anticoagulants, especially in older people [ 9 , 15 , 16 ].…”