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: Article (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material.
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: Article (PostPrint)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you may not distribute the modified material. Exportado de SIDERAL (2024-01-22-15:28:37)
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Record created 2024-01-22, last modified 2024-01-22