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

Abstract

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 >30s.

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 CHA₂DS₂-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.

Keywords: Anticoagulation; Atrial fibrillation; Risk scores.