Use of thromboprophylaxis guidelines and risk stratification tools in atrial fibrillation: A survey of general practitioners in Australia

Abstract

Rationale and Objectives: Clinical guidelines produced by cardiology societies (henceforth referred to simply as 'clinical guidelines') recommend thromboprophylaxis with oral anticoagulants (OACs) in patients with atrial fibrillation (AF) who have moderate-to-high stroke risk. However, deviations from these recommendations are observed, especially in the primary healthcare setting. The primary aims of this study were to evaluate the self-reported use of AF clinical guidelines and risk stratification tools among Australian general practitioners (GPs), and their perceptions regarding the available resources. Method:We conducted an online survey of Australian GPs. Descriptive statistics were used to summarise the findings.Results: Responses from 115 GPs were included for analysis. Respondents reported various ways of accessing thromboprophylaxis-related information (n = 113), including clinical guidelines (13.3%), 'Therapeutic Guidelines © ' (37.2%) and Royal Australian College of General Practitioners websites (16.8%). Of those who reported reasons against accessing information from clinical guidelines (n = 97), the most frequent issues were: too many AF guidelines to choose from (34.0%; 33/97), different guidelines for different diseases (32.0%; 31/97), time-consuming to read guidelines (21.6%; 21/97), disagreements between different guideline recommendations (20.0%; 19/97), conflict with criteria for government subsidy (17.5%; 17/97) and GPs' busy schedules (15.5%; 15/97). When assessing patients' risk of stroke (n = 112) and bleeding (n = 111), the majority of the respondents reported primarily relying on a formal stroke risk (67.0%) and bleeding risk (55.0%) assessment tools, respectively. Respondents reported using formal stroke and bleeding risk assessment tools mainly when newly initiating patients on therapy (72.4%; 76/105 and 65.3%; 65/101, respectively).Conclusion: Among our small sample of Australian GPs, most did not access thromboprophylaxis-related information directly from AF-specific clinical guidelines

Research progress on the role of ferroptosis in cardiovascular disease

“…Atrial fibrillation (AF) is the most clinically diagnosed arrhythmia ( 22 ). Most patients with AF are prone to recurrent attacks, presenting clinicians with a dilemma ( 23 ).…”

The Role of Ferroptosis in Atrial Fibrillation: A Promising Future

“…The activity of sodium, potassium, and calcium channels can be adversely impacted by iron overload, disrupting appropriate cardiac electrophysiology and codifying the biophysical association between iron ions and arrhythmias [ 12 ]. As the most commonly diagnosed form of cardiac arrhythmias, AF is also emerging as a particularly prominent focus in the field of ferroptosis [ 13 ].…”