Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: The ATA AF study

被引：65

作者：

Di Pasquale, Giuseppe ^{[1
]}

Mathieu, Giovanni ^{[2
]}

Maggioni, Aldo Pietro ^{[3
]}

Fabbri, Gianna ^{[3
]}

Lucci, Donata ^{[3
]}

Vescovo, Giorgio ^{[4
]}

Pirelli, Salvatore ^{[5
]}

Chiarella, Francesco ^{[6
]}

Scherillo, Marino ^{[7
]}

Gulizia, Michele Massimo ^{[8
]}

Gussoni, Gualberto ^{[9
]}

Colombo, Fabrizio ^{[10
]}

Panuccio, Domenico ^{[11
]}

Nozzoli, Carlo ^{[12
]}

Berisso, Massimo Zoni ^{[13
]}

机构：

[1] Maggiore Hosp, Dept Cardiol, Bologna, Italy

[2] Pinerolo Hosp, Dept Internal Med, Pinerolo, Italy

[3] ANMCO Res Ctr, I-50121 Florence, Italy

[4] San Bortolo Hosp, Dept Med, Vicenza, Italy

[5] Ist Ospitalieri, Dept Cardiol, Cremona, Italy

[6] San Martino Hosp, Dept Cardiol, Genoa, Italy

[7] Azienda Osped Rummo, Dept Intervent Cardiol, Benevento, Italy

[8] Garibaldi Nesima Hosp, Dept Cardiol, Catania, Italy

[9] FADOI Res Ctr, Milan, Italy

[10] Osped Niguarda Ca Granda, Dept Internal Med 1, Milan, Italy

[11] Maggiore Hosp, Dept Internal Med, Bologna, Italy

[12] Azienda Osped Careggi, Dept Internal Med, Florence, Italy

[13] Padre Antero Micone Hosp, Dept Cardiol, Genoa, Italy

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2013年 / 167卷 / 06期

关键词：

Atrial fibrillation; Guidelines; Anticoagulation; Rhythm control; Rate control; EURO HEART SURVEY; ANTITHROMBOTIC TREATMENT; RISK STRATIFICATION; WARFARIN USE; STROKE RISK; ANTICOAGULATION; GUIDELINES; RHYTHM; PREVALENCE; PREDICTORS;

D O I：

10.1016/j.ijcard.2012.07.019

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: Atrial fibrillation (AF) is associated with a high risk of stroke and mortality. Aims: To describe the difference in AF management of patients (pts) referred to Cardiology (CARD) or Internal Medicine (MED) units in Italy. Methods and results: From May to July 2010, 360 centers enrolled 7148 pts (54% in CARD and 46% in MED). Median age was 77 years (IQR 70-83). Hypertension was the most prevalent associated condition, followed by hypercholesterolemia (28.9%), heart failure (27.7%) and diabetes (24.3%). MED pts were older, more frequently females and more often with comorbidities than CARD pts. In the 4845 pts with nonvalvular AF, a CHADS(2) score >= 2 was present in 53.0% of CARD vs 75.3% of MED pts (p<.0001). Oral anticoagulants (OAC) were prescribed in 64.2% of CARD vs 46.3% of MED pts (p<.0001); OAC prescription rate was 49.6% in CHADS(2) 0 and 56.2% in CHADS(2) score >= 2 pts. At the adjusted analysis patients managed in MED had a significantly lower probability to be treated with OAC. Rate control strategy was pursued in 51.4% of the pts (60.5% in MED and 43.6% in CARD) while rhythm control was the choice in 39.8% of CARD vs 12.9% of MED pts (p<.0001). Conclusions: Cardiologists and internists seem to manage pts with large epidemiological differences. Both CARD and MED specialists currently fail to prescribe OAC in accordance with stroke risk. Patients managed by MED specialists have a lower probability to receive an OAC treatment, irrespective of the severity of clinical conditions. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

引用

页码：2895 / 2903

页数：9

共 26 条

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Adherence to guidelines for atrial fibrillation management of patients referred to cardiology departments: Studio Italiano multicentrico sul Trattamento della Fibrillazione Atriale (SITAF) [J].