by Elana Gotkine

For patients newly diagnosed with atrial fibrillation (AF) during hospitalization for other causes, most are not dispensed anticoagulants in the year after discharge, although some have a stroke risk approximating the threshold for initiation, according to a study published online April 22 in the Annals of Internal Medicine.

Husam Abdel-Qadir, M.D., Ph.D., from the University of Toronto, and colleagues conducted a population-based retrospective cohort study involving patients aged 66 years or older discharged alive from the hospital between April 2013 and March 2023 with a first diagnosis of AF to describe their risk for stroke.

The researchers found that AF was diagnosed in 20, 639 patients while hospitalized for other causes: 40.4%, 34.4%, 17.2%, and 8.0% for noncardiac medical, cardiac surgical, noncardiac surgical, and cardiac medical diagnoses, respectively. Anticoagulants were being dispensed to 26.4% and 35.2% of patients with CHA2DS2-VA scores of 1 to 4 and 5 to 8, respectively, at one year.

The one-year risk for stroke without anticoagulation was 1.3%, 1.2%, 1.1%, and 1.0% for cardiac medical, noncardiac medical, noncardiac surgical, and cardiac surgical patients, respectively. The one-year stroke risk was 0.7% and 1.8% without anticoagulation for patients with CHA2DS2-VA scores of 1 to 4 and 5 to 8, respectively.

"The risk for stroke in patients with higher CHA2DS2-VA scores and those hospitalized with cardiac medical diagnoses may exceed the recommended thresholds for anticoagulation for stroke prophylaxis, raising the need for future research focused on those patient groups, " the authors write.

More information: Husam Abdel-Qadir et al, Risk for Stroke After Newly Diagnosed Atrial Fibrillation During Hospitalization for Other Primary Diagnoses, Annals of Internal Medicine (2025). DOI: 10.7326/ANNALS-24-01967 Nimesh S. Patel et al, A New Perspective on Atrial Fibrillation "Provoked" by Hospitalization, Annals of Internal Medicine (2025). DOI: 10.7326/ANNALS-25-01073  Journal information: Annals of Internal Medicine

Nimesh S. Patel et al, A New Perspective on Atrial Fibrillation "Provoked" by Hospitalization, Annals of Internal Medicine (2025). DOI: 10.7326/ANNALS-25-01073

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