Prevalence of oral anticoagulation in atrial fibrillation

Atrial fibrillation is the most common sustained arrhythmia and is associated with poor outcomes, including stroke. The ability of anticoagulation therapy to reduce the risk of stroke has been well established; however, the prevalence of anticoagulation therapy use in the Public Health System is unk...

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Vydané v:Clinics (São Paulo, Brazil) Ročník 69; číslo 9; s. 615 - 620
Hlavní autori: Bartholomay, Eduardo, Polli, Ismael, Borges, Anibal Pires, Kalil, Carlos, Arroque, André, Kohler, Ilmar, Danzmann, Luiz Cláudio
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Brazil Elsevier España, S.L.U 01.09.2014
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Faculdade de Medicina / USP
Elsevier España
Predmet:
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Anticoagulation
Atrial Fibrillation
Atrial Fibrillation - complications
Clinical Science
Cross-Sectional Studies
Electrocardiography - statistics & numerical data
Female
Hemorrhage - chemically induced
Humans
Male
MEDICINE, GENERAL & INTERNAL
Middle Aged
Risk Assessment
Risk Factors
Stroke
Stroke - prevention & control
Thromboembolism - chemically induced
Treatment Outcome
Atrial Fibrillation
Stroke
Anticoagulation
ISSN:1807-5932, 1980-5322, 1980-5322
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Shrnutí:Atrial fibrillation is the most common sustained arrhythmia and is associated with poor outcomes, including stroke. The ability of anticoagulation therapy to reduce the risk of stroke has been well established; however, the prevalence of anticoagulation therapy use in the Public Health System is unknown. The aim of this study is to evaluate both the prevalence of anticoagulation therapy among patients with atrial fibrillation and the indications for the treatment. In this cross-sectional study, we included consecutive patients who had atrial fibrillation documented by an electrocardiogram performed between September 2011 and March 2012 at a university hospital of the Public Health System. The variables analyzed included the risk of a thromboembolic event and/or bleeding, the use of antiplatelet or anticoagulation therapy, the location where the electrocardiogram report was initially reviewed and the specialty of the physician who initially reviewed it. We included 162 patients (mean age 68.9 years, 56% men). Hypertension (90.1%), heart failure (53.4%) and stroke (38.9%) were the most prevalent diseases found. Only 50.6% of the patients knew that they had atrial fibrillation. Regarding the use of therapy, only 37.6% of patients classified as high risk according to the CHADS2 scores and 35.5% according to the CHA2DS2VASc used oral anticoagulation. A presumptive diagnosis of heart failure and the fact that the electrocardiogram was evaluated by a cardiologist were the only independent predictors of the use of anticoagulants. Our study found a low prevalence of oral anticoagulation therapy among patients with atrial fibrillation and an indication for stroke prophylaxis for the use of this therapy, including among those with high CHADS2 and CHA2DS2VASc scores.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Bartholomay E, Polli I, Borges AP, Kalil C, Arroque A, Kohler I, Danzmann LC conceived and designed the study and were responsible for data acquisition, analysis and interpretation, drafting and critical review of the manuscript.
ISSN:1807-5932
1980-5322
1980-5322
DOI:10.6061/clinics/2014(09)07