Atrial fibrillation (AF) has long been known to increase the risk of stroke. As a result, relevant international guidelines recommend that measures to reduce the risk of thrombus formation should be considered in all patients presenting with AF. Based on risk assessment scores, patients would then receive either thrombocyte aggregation inhibitors or oral anticoagulants. Despite this advice, compliance rates with the recommendations are poor across all countries surveyed. Evidence from the Global Anticoagulant Registry in the Field (GARFIELD) registry shows that major deviation from guidelines is due in large part to physicians’ decision-making. In this brief narrative review, we address some of the frequent reasons cited by physicians why the guidelines are disregarded for Asian patients.
Atrial fibrillation (AF) increases the risk of stroke 5-fold in Caucasians. While the relative risk for stroke is somewhat lower in Asia, estimated at 3.6% in Singapore, total AF and stroke-associated mortality rates are reported to be similar.
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