Profile of CZECH AF 2012. Profile of atrial fibrillation patients receiving antithrombotic therapy
- 1 June 2014
- journal article
- Published by Czech Society of Cardiology in Cor et Vasa
- Vol. 56 (3), e207-e216
- https://doi.org/10.1016/j.crvasa.2014.04.001
Abstract
The profile of Czech AF 2012 is an epidemiological survey conducted by 197 Czech internal medicine and cardiology specialists who aimed to provide a comprehensive view of patients with non-valvular atrial fibrillation and their treatment in the Czech Republic. Each specialist had to include 5 consecutive patients.It involved 982 patients with an average age of 69.9±10.04 years. The population of men was slightly higher (n=543, 55.3%), especially in the under 65 years age group; women were the majority in the age group above 75 years (44.3% of men, 55.7% of women).One quarter (25.1%) of patients were diagnosed with atrial fibrillation for less than 2 years; 23.2% for 2–5 years; 13.5% for 6–10 years, and 8.6% for more than 10 years. 20.7% of patients had paroxysmal atrial fibrillation; 58.5% indicated permanent atrial fibrillation, i.e. lasting more than one year. 58.7% of patients received medication to regulate heart rhythm; 44.0% had another antiarrhythmic medication. 13.8% of patients used their medication once a day; 55.1% twice a day, and 29.6% three times a day. 38.7% of patients were after cardioversion, 7.9% were after ablation. 91.5% of patients received warfarin alone or as dual (1.4%) therapy. Only 8.7% of patients had medium or severe kidney impairment. Only 7.5% of patients used acetylsalicylic acid, 0.2% used dual antiplatelet treatment.Only 3.0% of patients had CHADS2=0; 55.8% were at a medium risk (CHADS2=1–2), and 41.2% at a high risk (CHADS2>2). 22.1% had one associated condition; 27.5% had two associated conditions; 19.8% had three associated conditions; 28.7% had four or more associated conditions; and only 2.0% indicated no associated condition or gave no answer. The most common associated condition was hypertension (90.2%), followed by ischemic heart disease (50.9%) and diabetes mellitus (41.8%).95 patients (9.7%) had a history of embolism while receiving antithrombotic therapy. 102 patients (10.4%) had a clinically significant bleeding event while on antithrombotic therapy, 51 patients needed hospitalization.The average frequency of INR measurements was 10.2 per year (10.4 by cardiologists, 10.1 by internal medicine specialists). 61.6% were within the INR therapeutic range of 2–3.ConclusionAtrial fibrillation patients are commonly elderly, polymorbid and high-risk patients on a pharmacological medication two to three times a day. INR monitoring was close to the level described in large international studies, almost 2/3 of patients were within the therapeutic rangeKeywords
This publication has 32 references indexed in Scilit:
- 2012 focused update of the ESC Guidelines for the management of atrial fibrillationEuropean Heart Journal, 2012
- Apixaban versus Warfarin in Patients with Atrial FibrillationThe New England Journal of Medicine, 2011
- Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)European Heart Journal, 2010
- Progression From Paroxysmal to Persistent Atrial Fibrillation: Clinical Correlates and PrognosisJournal of the American College of Cardiology, 2010
- N-3 Fatty Acids for the Prevention of Atrial Fibrillation After Coronary Artery Bypass Surgery: A Randomized, Controlled TrialJournal of the American College of Cardiology, 2005
- The prevalence of atrial fibrillation in incident stroke cases and matched population controls in Rochester, Minnesota: Changes over three decadesJournal of the American College of Cardiology, 2003
- Prevalence of Diagnosed Atrial Fibrillation in AdultsJAMA, 2001
- Atrial fibrillation: current knowledge and recommendations for management*1European Heart Journal, 1998
- Secular trends in the prevalence of atrial fibrillation: The Framingham studyAmerican Heart Journal, 1996
- Risk Factors for Stroke and Efficacy of Antithrombotic Therapy in Atrial FibrillationArchives of Internal Medicine, 1994