| AF-ALERT: Online clinical decision support system is powerful tool for prevention of cardiovascular events in patients with atrial fibrillation An alert-based computerized decision support system that is designed to increase anticoagulation for stroke prevention in high-risk hospitalized atrial fibrillation (AF) patients may reduce major adverse cardiovascular events. The AF-ALERT trial evaluated an alert-based computerized decision support (CDS) strategy to increase anticoagulation prescription among 457 hospitalized AF patients at high-risk for stroke. Results were presented during a Late Breaking Clinical Trials session at the American Heart Association Scientific Sessions 2018. Researchers looked at 457 hospitalized high-risk patients (CHA2DS2-VASc score≥1) ≥21 years with AF or atrial flutter who were not prescribed anticoagulant therapy for stroke prevention. Patients were randomly assigned to an alert-based computerized decision support system vs. usual care. This provider-directed, alert-based computerized decision support tool for hospitalized high-risk AF halved the rate of a composite outcome of death, MI, cerebrovascular accident (stroke or TIA), and systemic embolic event at 90 days. The computer alert increased prescription of anticoagulation for stroke prevention in AF during hospitalization, at discharge, and at 90 days after randomization and encouraged the use of guideline-preferred direct oral anticoagulants. "This alert-based computerized decision support strategy increased prescription of anticoagulation in hospitalized patients with AF who were not receiving antithrombotic therapy despite an increased risk of stroke." Says Gregory Piazza, MD, FACC of Brigham and Women's Hospital in Boston, MA, USA. He suggests that an alert-based CDS should be considered an indispensable tool to reduce major adverse cardiac events in patients with AF. |