Características basales, manejo de terapias antitrombóticas y pronóstico de pacientes chilenos con FA no valvular. Lecciones del Registro GARFIELD AF en Chile
| Autor: | Fernando Lanas, Patricio Marín, Martín Larico, Gustavo Charme, Benjamín Stockins, Carlos Rey, Juan Segura Aguilar, Carlos Conejeros, César Houzvic, Ramón Corbalán, Sergio Potthoff, Germán Eggers, Claudio Bugueño, Carlos Astudillo, Humberto Montecinos, Germán Arriagada |
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| Rok vydání: | 2017 |
| Předmět: |
High rate
HAS-BLED medicine.medical_specialty business.industry Anticoagulants Cardiac arrhythmia Atrial fibrillation General Medicine 030204 cardiovascular system & hematology Prognosis medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Internal medicine Atrial Fibrillation Antithrombotic medicine Chile business Prospective cohort study Risk assessment Stroke 030217 neurology & neurosurgery |
| Zdroj: | Revista médica de Chile v.145 n.8 2017 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| Popis: | Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with high rates of death, ischemic stroke and systemic embolism (SE). There is scarce information about clinical characteristics and use of anti-thrombotic therapies in Chilean patients with non-valvular AF. Aim: To describe the characteristics and 1-year outcomes of patients with recently diagnosed AF recruited in Chile into the prospective global GARFIELD-AF registry. Material and Methods: Between 2011-2016, we prospectively registered information of 971 patients recruited at 15 centers, 85% of them from the public system and 15% from the private sector. Demographics, clinical characteristics and use of antithrombotic therapies were recorded for all patients. Adverse clinical outcomes were analyzed in 711 patients with 1-year follow-up. Results: The mean age was 71.5 years (66-79), 50% were men. Mean CHAD2S2 Vasc and HAS BLED scores for stroke risk were 3.3 (2.0-4.0) and 1.5 (1.0-2.0) respectively. Oral anticoagulants were prescribed in 82% of patients. Seventy percent received Vitamin K antagonists, 10% novel direct anticoagulants or antiplatelet therapy and only 8% did not receive any antithrombotic therapy. Mean time in optimal therapeutic range (an international normalized ratio of 2 to 3), was achieved in only 40.7% (23.0-54.8) of patients receiving Vitamin K antagonists. One year rates of death, stroke/systemic embolism and bleeding were 4.75 (3.36-6.71), 2.40 (1.47-3.92) and 1.64% (0.91-2.97) per 100 person-years. Ischemic stroke occurred in 1.8% and hemorrhagic stroke in 0.8% of patients at 1-year of follow up. Conclusions: Although the use of vitamin K antagonists at baseline was high, the mean time in optimal therapeutic range was low. Mortality and stroke rates are higher than those reported in other contemporary registries. |
| Databáze: | OpenAIRE |
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