Evaluation of atrial fibrillation management and cardiovascular risk profile in atrial fibrillation patients: A cross-sectional survey

被引:2
作者
Rackauskas, Gediminas [1 ]
Zabiela, Vytautas [2 ]
Marinskis, Germanas [1 ]
Baranauskas, Arvydas [1 ]
Balkute, Deimile [1 ]
Alunderyte, Justina [1 ]
Puodziukynas, Aras [2 ]
Kazakevicius, Tomas [2 ]
Kviesulaitis, Vilius [2 ]
Aidietis, Audrius [1 ]
机构
[1] Vilnius Univ, Ctr Cardiol & Angiol, Dept Cardiovasc Dis, Santariskiu 2, LT-08661 Vilnius, Lithuania
[2] Lithuanian Univ Hlth Sci, Med Acad, Dept Cardiol, Kaunas, Lithuania
来源
MEDICINA-LITHUANIA | 2017年 / 53卷 / 01期
关键词
Atrial fibrillation; Risk scores; Anticoagulation; MEMBER COUNTRIES; STROKE;
D O I
10.1016/j.medici.2017.01.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: The aim of this study to investigate the most frequent risk factors of atrial fibrillation (AF), co-morbidities, complications associated with AF and the use of anticoagulants and other medications in patients who were referred to university hospitals in Lithuania. Materials and methods: This cross-sectional study enrolled consecutive inpatients and outpatients with AF presenting to cardiologists in the two biggest Lithuanian university hospitals from November 2013 to May 2014. AF diagnosis was confirmed by a 12-lead ECG or 24-h Holter with an episode duration of >30 s. Results: A total number of 575 patients were recruited, and complete data on clinical subtype were available for 515 patients (mean age of 70.7 years; 48.5% of women). Permanent AF was the most frequent type of AF (46.6%). Common comorbidities were hypertension (85.8%), heart failure (77.9%) and coronary artery disease (51.8%). Amiodarone was the most common antiarrhythmic agent used in 14.6% of the patients, while beta-blockers and digoxin were the most often used rate control drugs (59.6% and 10.7%, respectively). Oral anticoagulants were used by 53.3% of the patients; of them, 95.6% used vitamin K antagonists, while non-vitamin K antagonist were used by only 4.4%. The INR within a therapeutic range (2.0-3.0) was documented in 19.2% of the patients. Other antithrombotic drugs such as aspirin and clopidogrel were used in 13.7% and 2.0% of the patients, respectively; dual antiplatelet treatment was administered in 6.2% of the patients. Of the entire cohort, the mean CHA(2)DS(2)-VASc score was 3.97 +/- 1.6 and the mean HAS-BLED score was 2.25 +/- 1.0. Conclusions: Compliance with the treatment guidelines remains suboptimal and further patient education is needed. (C) 2017 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Sp. z o.o.
引用
收藏
页码:19 / 25
页数:7
相关论文
共 18 条
[1]   Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus no treatment in a 'real world' atrial fibrillation population: A modelling analysis based on a nationwide cohort study [J].
Banerjee, Amitava ;
Lane, Deirdre A. ;
Torp-Pedersen, Christian ;
Lip, Gregory Y. H. .
THROMBOSIS AND HAEMOSTASIS, 2012, 107 (03) :584-589
[2]   Shattuck lecture - Cardiovascular medicine at the turn of the millennium: Triumphs, concerns, and opportunities [J].
Braunwald, E .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (19) :1360-1369
[3]   2012 focused update of the ESC Guidelines for the management of atrial fibrillation [J].
Camm, A. John ;
Lip, Gregory Y. H. ;
De Caterina, Raffaele ;
Savelieva, Irene ;
Atar, Dan ;
Hohnloser, Stefan H. ;
Hindricks, Gerhard ;
Kirchhof, Paulus ;
Bax, Jeroen J. ;
Baumgartner, Helmut ;
Ceconi, Claudio ;
Dean, Veronica ;
Deaton, Christi ;
Fagard, Robert ;
Funck-Brentano, Christian ;
Hasdai, David ;
Hoes, Arno ;
Knuuti, Juhani ;
Kolh, Philippe ;
McDonagh, Theresa ;
Moulin, Cyril ;
Popescu, Bogdan A. ;
Reiner, Zeljko ;
Sechtem, Udo ;
Sirnes, Per Anton ;
Tendera, Michal ;
Torbicki, Adam ;
Vahanian, Alec ;
Windecker, Stephan ;
Vardas, Panos ;
Al-Attar, Nawwar ;
Alfieri, Ottavio ;
Angelini, Annalisa ;
Blomstrom-Lundqvist, Carina ;
Colonna, Paolo ;
De Sutter, Johan ;
Ernst, Sabine ;
Goette, Andreas ;
Gorenek, Bulent ;
Hatala, Robert ;
Heidbuchel, Hein ;
Heldal, Magnus ;
Kristensen, Steen Dalby ;
Le Heuzey, Jean-Yves ;
Mavrakis, Hercules ;
Mont, Lluis ;
Filardi, Pasquale Perrone ;
Ponikowski, Piotr ;
Prendergast, Bernard ;
Rutten, Frans H. .
EUROPEAN HEART JOURNAL, 2012, 33 (21) :2719-2747
[4]   KCNQ1 gain-of-function mutation in familial atrial fibrillation [J].
Chen, YH ;
Xu, SJ ;
Bendahhou, S ;
Wang, XL ;
Wang, Y ;
Xu, WY ;
Jin, HW ;
Sun, H ;
Su, XY ;
Zhuang, QN ;
Yang, YQ ;
Li, YB ;
Liu, Y ;
Xu, HJ ;
Li, XF ;
Ma, N ;
Mou, CP ;
Chen, Z ;
Barhanin, J ;
Huang, W .
SCIENCE, 2003, 299 (5604) :251-254
[5]   Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring [J].
Fox, CS ;
Parise, H ;
D'Agostino, RB ;
Lloyd-Jones, DM ;
Vasan, RS ;
Wang, TJ ;
Levy, D ;
Wolf, PA ;
Benjamin, EJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (23) :2851-2855
[6]   ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society [J].
Fuster, Valentin ;
Ryden, Lars E. ;
Cannom, David S. ;
Crijns, Harry J. ;
Curtis, Anne B. ;
Ellenbogen, Kenneth A. ;
Halperin, Jonathan L. ;
Le Heuzey, Jean-Yves ;
Kay, G. Neal ;
Lowe, James E. ;
Olsson, S. Bertil ;
Prystowsky, Eric N. ;
Tamargo, Juan Luis ;
Wann, Samuel .
CIRCULATION, 2006, 114 (07) :E257-E354
[7]   Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins [J].
Haïssaguerre, M ;
Jaïs, P ;
Shah, DC ;
Takahashi, A ;
Hocini, M ;
Quiniou, G ;
Garrigue, S ;
Le Mouroux, A ;
Le Métayer, P ;
Clémenty, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (10) :659-666
[8]   Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation [J].
Hart, Robert G. ;
Pearce, Lesly A. ;
Aguilar, Maria I. .
ANNALS OF INTERNAL MEDICINE, 2007, 146 (12) :857-867
[9]   Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation [J].
Hylek, EM ;
Go, AS ;
Chang, YC ;
Jensvold, NG ;
Henault, LE ;
Selby, JV ;
Singer, DE .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (11) :1019-1026
[10]  
Kirchhof P, 2016, EUR J CARDIO-THORAC, V2016