The European Society of Cardiology quality indicators in atrial fibrillation in centers of excellence in Spain: the SEC-EXCELENTE FA registry.

Autor: Ruiz Ortiz M; Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Spain; Universidad Internacional Isabel I de Castilla, Burgos, Spain. Electronic address: maruor@gmail.com., Arbelo E; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Spain; Sección de Arritmias, Servicio de Cardiología, Hospital Clínic, Universidad de Barcelona, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain; European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart (ERN GUARD-Heart), Amsterdam, The Netherlands., Roldán Rabadán I; Servicio de Cardiología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain., Marín F; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain., Pérez Cabeza A; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain., Marzoa Rivas R; Servicio de Cardiología, Hospital Universitario de Ferrol, A Coruña, Spain., Peinado Peinado R; Servicio de Cardiología, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain., Valle Alberca A; Servicio de Cardiología, Hospital Costa del Sol, Marbella, Málaga, Spain., Ibáñez Criado A; Servicio de Cardiología, Hospital General Universitario, Alicante, Spain., Valle Muñoz A; Servicio de Cardiología, Hospital Marina Salud, Denia, Alicante, Spain., Osca Asensi J; Servicio de Cardiología, Hospital Universitario La Fe, Valencia, Spain., Del Río Lechuga A; Servicio de Cardiología, Hospital Universitario, Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain., Elola Somoza FJ; Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain., Anguita Sánchez M; Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, Córdoba, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Spain., Ruiz Ortiz M; Hospital Universitario Reina Sofía, Córdoba, Spain., Peinado Peinado R; Hospital Universitario La Paz, Madrid, Spain., Arbelo Laínez E; Hospital Clinic, Barcelona, Spain., Valle Alberca A; Hospital Costa Del Sol, Marbella (Málaga), Spain., Ibáñez Criado A; Hospital General Universitario de Alicante, Alicante, Spain., Valle Muñoz A; Hospital Marina Salud, Denia, Alicante, Spain., Osca Asensi J; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Río Lechuga AD; Hospital Universitario de Jerez de La Frontera, Cádiz, Spain., Pérez Cabeza AI; Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2024 Sep 18. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1016/j.rec.2024.08.007
Abstrakt: Introduction and Objectives: By 2022, 9 centers had been accredited by the Spanish Society of Cardiology for the atrial fibrillation (AF) process. Our objective was to evaluate the performance of these centers based on the quality indicators (QIs) proposed by the European Society of Cardiology (ESC) in 2020.
Methods: Adults with AF who were attended in the cardiology departments of participating centers during the second week of May 2019 were included in a retrospective registry (n=797, age 72±11 years, 60% male). Key ESC QIs were assessed.
Results: CHA 2 DS 2 -VASc, HAS-BLED scores, and serum creatinine levels were documented in 24.9%, 6.1%, and 96.2% of patients, respectively. Anticoagulation was appropriately prescribed in 90.6% of high-risk patients according to the CHA 2 DS 2 -VASc score, but was inappropriately prescribed in 57.8% of low-risk patients. Among all patients, 84.1% received high-quality anticoagulation. Inappropriate antiarrhythmic drugs were prescribed in 7.2% of patients with permanent AF, 2.9% of those with structural heart disease, and 0.0% of those with end-stage kidney disease. Catheter ablation was offered to 70% of patients with symptomatic paroxysmal or persistent AF after the failure or intolerance of 1 antiarrhythmic drug. All modifiable risk factors were documented in 59.3% of patients. Rates of all-cause mortality, ischemic stroke or transient ischemic attack, and major bleeding were 8.1, 0.8, and 2.56 per 100 patients/y, respectively. QIs for anticoagulation and outcomes were similar between general cardiology and tertiary referral centers.
Conclusions: Although accredited centers in Spain demonstrated good performance in many of the ESC QIs for AF, there remains room for improvement. These data could serve as a starting point for enhancing the quality of care in this population.
(Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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