Adherence to guidelines and mortality in atrial fibrillation
Diez-Manglano J (Universidad de Zaragoza) ; Gomes-Martín J ; Al-Cheikh-Felices P ; Isasi de Isasmendi Pérez S ; Díez-Angulo R ; Clemente-Sarasa C
Resumen: Objective
Determining the adherence to ACC/AHA/ESC 2006 guidelines and its influence on the survival of patients with atrial fibrillation.
Methods
Prospective observational study of patients discharged during 2007 from an Internal Medicine department with a main or secondary diagnose of atrial fibrillation. The stroke risk was estimated with the CHADS2 score. The follow-up was carried out in outpatient medical office or via telephone.
Results
We included 259 patients (mean age 80.9 years); 73% of them had a high risk of stroke. Oral anticoagulants were administered to 134 (51.7%), and antiplatelet drugs to 71 (27%) patients. A rate control strategy was chosen for 155 (59.8%) patients and a rhythm control one for 28 (10.8%). In 100 (38.6%) patients, treatment was adherent to the guidelines. Adherence to the guidelines was associated with age (0.95 95%CI 0.92–0.99; p = 0.03), contraindication to the use of oral anticoagulants (0.38 95%CI 0.18–0.81; p = 0.01) and mitral valve heart disease/valvular prosthesis (2.10 95%CI 1.04–4.25; p = 0.04). The median follow-up was 727 days, and 191 patients died. Patients treated according to the guidelines had a higher rate of survival during the first three years (0.47 vs. 0.36; p = 0.049). The use of oral anticoagulants was associated with a higher probability of survival over a 5 year period (0.34 vs 0.21; p = 0.001) and the rate control strategy during the first year (0.69 vs 0.57; p = 0.04).
Conclusions
In the real world, the treatment of atrial fibrillation according to the guidelines is associated with improved survival for up to three years during follow-up.
Idioma: Inglés
DOI: 10.1016/j.ijcard.2014.07.098
Año: 2014
Publicado en: INTERNATIONAL JOURNAL OF CARDIOLOGY 176, 2 (2014), 430-436
ISSN: 0167-5273
Factor impacto JCR: 4.036 (2014)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 29 / 123 = 0.236 (2014) - Q1 - T1
Tipo y forma: Artículo (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
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Exportado de SIDERAL (2024-01-22-15:28:37)
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Determining the adherence to ACC/AHA/ESC 2006 guidelines and its influence on the survival of patients with atrial fibrillation.
Methods
Prospective observational study of patients discharged during 2007 from an Internal Medicine department with a main or secondary diagnose of atrial fibrillation. The stroke risk was estimated with the CHADS2 score. The follow-up was carried out in outpatient medical office or via telephone.
Results
We included 259 patients (mean age 80.9 years); 73% of them had a high risk of stroke. Oral anticoagulants were administered to 134 (51.7%), and antiplatelet drugs to 71 (27%) patients. A rate control strategy was chosen for 155 (59.8%) patients and a rhythm control one for 28 (10.8%). In 100 (38.6%) patients, treatment was adherent to the guidelines. Adherence to the guidelines was associated with age (0.95 95%CI 0.92–0.99; p = 0.03), contraindication to the use of oral anticoagulants (0.38 95%CI 0.18–0.81; p = 0.01) and mitral valve heart disease/valvular prosthesis (2.10 95%CI 1.04–4.25; p = 0.04). The median follow-up was 727 days, and 191 patients died. Patients treated according to the guidelines had a higher rate of survival during the first three years (0.47 vs. 0.36; p = 0.049). The use of oral anticoagulants was associated with a higher probability of survival over a 5 year period (0.34 vs 0.21; p = 0.001) and the rate control strategy during the first year (0.69 vs 0.57; p = 0.04).
Conclusions
In the real world, the treatment of atrial fibrillation according to the guidelines is associated with improved survival for up to three years during follow-up.
Idioma: Inglés
DOI: 10.1016/j.ijcard.2014.07.098
Año: 2014
Publicado en: INTERNATIONAL JOURNAL OF CARDIOLOGY 176, 2 (2014), 430-436
ISSN: 0167-5273
Factor impacto JCR: 4.036 (2014)
Categ. JCR: CARDIAC & CARDIOVASCULAR SYSTEMS rank: 29 / 123 = 0.236 (2014) - Q1 - T1
Tipo y forma: Artículo (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Debe reconocer adecuadamente la autoría, proporcionar un enlace a la licencia e indicar si se han realizado cambios. Puede hacerlo de cualquier manera razonable, pero no de una manera que sugiera que tiene el apoyo del licenciador o lo recibe por el uso que hace. No puede utilizar el material para una finalidad comercial. Si remezcla, transforma o crea a partir del material, no puede difundir el material modificado.Exportado de SIDERAL (2024-01-22-15:28:37)
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Registro creado el 2024-01-22, última modificación el 2024-01-22