Use of oral anticoagulation among stroke patients with atrial fibrillation in China: the ChinaQUEST (Quality evaluation of stroke care and treatment) registry study

Background International guidelines recommend oral anticoagulation in patients with atrial fibrillation according to their level of stroke risk. This study aimed to determine oral anticoagulation use in atrial fibrillation patients with recent ischemic stroke and examine factors that impact such management in China. Methods Among the patients with acute ischemic stroke (n=4782) from the China QUality Evaluation of Stroke Care and Treatment study, a multicenter, prospective, 62-hospital registry in China, there were 499 (10%) (mean age 70 +/- 12years, 49% female) with documented atrial fibrillation with outcome data over 12months of follow-up. Logistic regression analysis was used to identify the independent predictors of oral anticoagulation use in these patients. Results Of the 499 stroke patients with atrial fibrillation, oral anticoagulation use was 20% overall but varied from 8% prestroke and 11% in-hospital (poststroke), to 13% and 10% at three-months and 12months, respectively. Oral anticoagulation use was independently associated with younger age (odds ratio 0 center dot 95, 95% confidence interval 0 center dot 930 center dot 97, P<0 center dot 001), nonmanual occupation (odds ratio 0 center dot 44, 95% confidence interval 0 center dot 250 center dot 80, P=0 center dot 006), and less cardiovascular risk factors (odds ratio 0 center dot 81, 95% confidence interval 0 center dot 680 center dot 96, P=0 center dot 02). Conclusions These data indicate oral anticoagulation use is lower in stroke patients with atrial fibrillation in China than that in Western countries, being applied more often in those of younger age, nonmanual occupation, and having less cardiovascular risk factors.