Characterization of Antithrombotic Regimens for Patients with Nonvalvular Atrial Fibrillation and Obesity Discharged from Cardiology Wards.

Abstract

Despite data derived from observational studies, optimal anticoagulation strategies have yet to be established for patients with nonvalvular atrial fibrillation and obesity. To describe direct oral anticoagulant (DOAC) regimens prescribed for adult patients with nonvalvular atrial fibrillation who weighed more than 120 kg. This single-centre, retrospective cohort study, conducted in the Saskatchewan Health Authority - Regina Area, involved adult patients with body weight greater than 120 kg who had an indication for oral anticoagulation to treat nonvalvular atrial fibrillation and were discharged by a cardiologist between June 2019 and July 2021. A total of 62 patients were included (median weight 135 kg). At discharge, DOACs were prescribed for 57 (92%) of the patients and warfarin for 5 (8%). In numeric terms, patients receiving warfarin were at higher risk of thromboembolism or thrombosis; however, the small sample size limited the ability to draw conclusions. Practice patterns in the Saskatchewan Health Authority - Regina Area indicated substantial use of DOACs for patients with body weight greater than 120 kg; however, for those with the highest weights, warfarin was still in use.