Patients with atrial fibrillation in a primary care setting: Val-FAAP study

Abstract

Objective: To assess the clinical characteristics of patients with atrial fibrillation in the primary care setting.

Methods: This was a 2-phase, cross-sectional, multicenter study: phase A assessed the proportion of atrial fibrillation patients assisted in primary care over 5 days; phase B analyzed atrial fibrillation patients' clinical characteristics and management.

Results: In phase A, 119 526 subjects (age 52.9 [15.2] years; 40.9% male) received primary care in participating centers; 6.1% had atrial fibrillation. This proportion increased with age, hypertension, and male sex. In phase B, we analyzed 3287 atrial fibrillation patients (age 71.9 [10.1] years; 52.3% male). Risk factors were hypertension (92.6%), hypercholesterolemia (70.6%), related cardiovascular disease, heart failure (21.3%), and ischemic heart disease (20.9%). Permanent atrial fibrillation was the most frequent type of atrial fibrillation (45.3%). Age and cardiac and renal diseases were related to permanent atrial fibrillation development. Although more than two-thirds of patients had a CHADS(2) score ≥2, about one-third of them were not taking anticoagulants; by contrast, 46.8% of patients with CHADS(2)=0 were taking oral anticoagulants.

Conclusions: In primary care, 6.1% of patients had atrial fibrillation. Patients with atrial fibrillation had high comorbidity. Anticoagulant treatment is far from optimal for atrial fibrillation patients in primary care.