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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18949

Title: Prevalence and antithrombotic management of atrial fibrillation in hospitalised patients
Authors: Berti, Dana
Moors, Eline
Moons, Philip
HEIDBUCHEL, Hein
Issue Date: 2015
Publisher: BMJ PUBLISHING GROUP
Citation: HEART, 101 (11), p. 884-893
Abstract: Objectives The objective of this study was to determine the prevalence of atrial fibrillation (AF) in a tertiary care centre, to describe the comorbidity profile of hospitalised patients with AF, and to evaluate the appropriateness of their maintenance antithrombotic management. Methods In a cross-sectional, descriptive study, all consenting hospitalised patients from 36 wards in a University hospital (excluding critical care units, psychiatric, maternity and paediatric wards) received an ECG on a single day. Also their charts were reviewed for key demographic and clinical data. For patients with AF, all factors and comorbidities comprising thromboembolic (CHA(2)DS(2)-VASc) and bleeding risk (HAS-BLED) were listed. The appropriateness of long-term anticoagulant therapy was assessed according to the 2010 international guidelines (CHA(2)DS(2)-VASc score 0=aspirin or no antithrombotic treatment; 1=aspirin or oral anticoagulant treatment (OAC); >= 2=OAC). The response rate was 79.7%, that is, an ECG was performed in 636 of 812 eligible hospitalised patients. Results AF was present on ECG in 58 patients reflecting a 9.1% hospital point prevalence (95% CI 6.9% to 11.3%). Of the remaining 587 participants, 49 had a history of AF. Hence, 107 AF cases were identified, yielding a total prevalence of 16.8% (95% CI 13.9% to 19.7%). Patients with AF were detected in every hospital zone, with highest prevalence rates in zone 'thorax' (29.3% (95% CI 22.2% to 36.4%)) and 'internal medicine' (21.7% (95% CI 14.8% to 28.6%)). Patients with AF were older than patients without AF (78.7 +/- 10.3 years versus 62.7 +/- 15.9 years; p<0.001). The most common associated comorbidities were hypertension (63.6%) and valvular heart disease (58.9%). Most patients with AF were at high risk for stroke (CHA(2)DS(2)-VASc-score >= 2 in 92.5%). Overall, only 51.3% of all patients did receive appropriate anticoagulant long-term management, while 31% were undertreated and 17.7% were possibly overtreated. Conclusions This hospital-based study revealed high AF prevalence rates (16.8%). Patients with AF were present in all hospital zones and almost all patients were at high risk for stroke. Anticoagulation management was likely inappropriate in 48.7%, indicating the need for better guideline implementation initiatives to guarantee hospital-wide optimised care for patients with AF.
Notes: [Berti, Dana] Univ Leuven, Univ Hosp Leuven, KU Leuven, Dept Cardiovas Med, Leuven, Belgium. [Moors, Eline; Moons, Philip] Univ Leuven, Ctr Hlth Serv & Nursing Res, KU Leuven, Dept Publ Hlth & Primary Care, Leuven, Belgium. [Moons, Philip] Copenhagen Univ Hosp, Ctr Heart, Copenhagen, Denmark. [Moons, Philip] Univ Gothenburg, Inst Hlth & Care Sci, Gothenburg, Sweden. [Heidbuchel, Hein] Hasselt Univ, Hasselt, Belgium. [Heidbuchel, Hein] Jessa Hosp, Heart Ctr Hasselt, Hasselt, Belgium.Correspondence to Dana Berti, Cardiology—Electrophysiology, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium; Dana.Berti@uzleuven.be
URI: http://hdl.handle.net/1942/18949
DOI: 10.1136/heartjnl-2014-307059
ISI #: 000354277600013
ISSN: 1355-6037
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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