Atrial Fibrillation: from the guidelines to the reality
Autor(a) principal: | |
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Data de Publicação: | 2006 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spmi.pt/index.php/rpmi/article/view/1640 |
Resumo: | Background: Atrial Fibrillation (AF) is a very frequent arrhythmia. A devastating consequence of AF is stroke and 15% of all strokes are caused by AF. Several trials have proved a significant reduction in the risk of stroke with anticoagulation (AC). New guidelines have suggested AC for at least three weeks after cardioversion and long term AC for patients older than 75 years with AF, as well as those with risk factors for a thromboembolic event. Long-term AC in the community is safe and effective, even in the elderly. However, some physicians avoid prescribing AC.Objectives: Determine the prevalence of AF in patients attending the Internal Medicine Department of Fernando Fonseca Hospital, over the last 9 years; study the prevalence of stroke in these patients; determine the use of AC at discharge of patients with AF in 2004.Design: retrospective, event driven clinical database analysis.Results: In 9 years AF was found in 6.7% (927/13800) of patients. In 2004, 122 patients with AF were hospitalised and 17.2% had cerebrovascular disease. AC on discharge was noted in only 22.2% of these patients. Conclusions: Even though it has been proved that AC reduces the risk of stroke in patients with AF, in general practice the number of patients anticoagulated is small. We must change this attitude in order to reduce the morbility and mortality associated to stroke, the leading cause of death in our country. |
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Atrial Fibrillation: from the guidelines to the realityFibrilhação auricular: das guidelines à realidadeFibrilhação auriculardoença cerebrovascularanticoagulação oralAtrial Fibrillationstroke preventionanticoagulationBackground: Atrial Fibrillation (AF) is a very frequent arrhythmia. A devastating consequence of AF is stroke and 15% of all strokes are caused by AF. Several trials have proved a significant reduction in the risk of stroke with anticoagulation (AC). New guidelines have suggested AC for at least three weeks after cardioversion and long term AC for patients older than 75 years with AF, as well as those with risk factors for a thromboembolic event. Long-term AC in the community is safe and effective, even in the elderly. However, some physicians avoid prescribing AC.Objectives: Determine the prevalence of AF in patients attending the Internal Medicine Department of Fernando Fonseca Hospital, over the last 9 years; study the prevalence of stroke in these patients; determine the use of AC at discharge of patients with AF in 2004.Design: retrospective, event driven clinical database analysis.Results: In 9 years AF was found in 6.7% (927/13800) of patients. In 2004, 122 patients with AF were hospitalised and 17.2% had cerebrovascular disease. AC on discharge was noted in only 22.2% of these patients. Conclusions: Even though it has been proved that AC reduces the risk of stroke in patients with AF, in general practice the number of patients anticoagulated is small. We must change this attitude in order to reduce the morbility and mortality associated to stroke, the leading cause of death in our country.Introdução: A fibrilhação auricular (FA) é uma disritmia frequente, encontrando-se associada à doença cerebrovascular (DCV). Quinze por cento dos acidentes vasculares cerebrais (AVC) estão directamente relacionados com a FA. Foi provado que a anticoagulação oral (ACO) reduz significativamente esta relação, sugerindo-se ACO nas 3 semanas seguintes à cardioversão e, a longo prazo, em doentes com mais de 75 anos ou que apresentem um ou mais factores de risco para DCV. A ACO a longo prazo é segura e benéfica, mesmo nos idosos. Contudo, na prática clínica diária os médicos evitam prescrever ACO.Objectivos: Determinar a prevalência de FA nos doentes internados num serviço de Medicina Interna do Hospital Fernando Fonseca nos últimos 9 anos; estudar a ocorrência de DCV nestes doentes; avaliar a utilização de ACO no momento da alta dos doentes internados por FA em 2004; Métodos: Estudo retrospectivo e descritivo, efectuado através da consulta da base de dados do serviço.Resultados: Em 9 anos 6,7% dos doentes internados (927/13800) apresentavam fibrilhação auricular. Em 2004 ocorreram 122 internamentos por FA; 17,2% foram hospitalizados por AVC ou tinham história de DCV no passado. A ACO foi utilizada apenas em 22,2%, a antiagregação em 58,3% e 19,4% não beneficiaram de nenhuma destas estratégias. Conclusões: Apesar de se saber que a ACO diminui o risco de DCV nos doentes com FA, o número de doentes anticoagulados, na prática, é pequeno. É necessário mudar esta atitude para lutar contra a DCV, principal causa de morte no nosso país.Sociedade Portuguesa de Medicina Interna2006-09-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spmi.pt/index.php/rpmi/article/view/1640Internal Medicine; Vol. 13 No. 3 (2006): Julho/ Setembro; 155-161Medicina Interna; Vol. 13 N.º 3 (2006): Julho/ Setembro; 155-1612183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/1640https://revista.spmi.pt/index.php/rpmi/article/view/1640/1106Costa Reis, PatríciaPatrícia, TerezaDutschmann, Luísinfo:eu-repo/semantics/openAccess2023-02-25T06:11:09Zoai:oai.revista.spmi.pt:article/1640Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:47:17.237970Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Atrial Fibrillation: from the guidelines to the reality Fibrilhação auricular: das guidelines à realidade |
title |
Atrial Fibrillation: from the guidelines to the reality |
spellingShingle |
Atrial Fibrillation: from the guidelines to the reality Costa Reis, Patrícia Fibrilhação auricular doença cerebrovascular anticoagulação oral Atrial Fibrillation stroke prevention anticoagulation |
title_short |
Atrial Fibrillation: from the guidelines to the reality |
title_full |
Atrial Fibrillation: from the guidelines to the reality |
title_fullStr |
Atrial Fibrillation: from the guidelines to the reality |
title_full_unstemmed |
Atrial Fibrillation: from the guidelines to the reality |
title_sort |
Atrial Fibrillation: from the guidelines to the reality |
author |
Costa Reis, Patrícia |
author_facet |
Costa Reis, Patrícia Patrícia, Tereza Dutschmann, Luís |
author_role |
author |
author2 |
Patrícia, Tereza Dutschmann, Luís |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Costa Reis, Patrícia Patrícia, Tereza Dutschmann, Luís |
dc.subject.por.fl_str_mv |
Fibrilhação auricular doença cerebrovascular anticoagulação oral Atrial Fibrillation stroke prevention anticoagulation |
topic |
Fibrilhação auricular doença cerebrovascular anticoagulação oral Atrial Fibrillation stroke prevention anticoagulation |
description |
Background: Atrial Fibrillation (AF) is a very frequent arrhythmia. A devastating consequence of AF is stroke and 15% of all strokes are caused by AF. Several trials have proved a significant reduction in the risk of stroke with anticoagulation (AC). New guidelines have suggested AC for at least three weeks after cardioversion and long term AC for patients older than 75 years with AF, as well as those with risk factors for a thromboembolic event. Long-term AC in the community is safe and effective, even in the elderly. However, some physicians avoid prescribing AC.Objectives: Determine the prevalence of AF in patients attending the Internal Medicine Department of Fernando Fonseca Hospital, over the last 9 years; study the prevalence of stroke in these patients; determine the use of AC at discharge of patients with AF in 2004.Design: retrospective, event driven clinical database analysis.Results: In 9 years AF was found in 6.7% (927/13800) of patients. In 2004, 122 patients with AF were hospitalised and 17.2% had cerebrovascular disease. AC on discharge was noted in only 22.2% of these patients. Conclusions: Even though it has been proved that AC reduces the risk of stroke in patients with AF, in general practice the number of patients anticoagulated is small. We must change this attitude in order to reduce the morbility and mortality associated to stroke, the leading cause of death in our country. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-09-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1640 |
url |
https://revista.spmi.pt/index.php/rpmi/article/view/1640 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1640 https://revista.spmi.pt/index.php/rpmi/article/view/1640/1106 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Internal Medicine; Vol. 13 No. 3 (2006): Julho/ Setembro; 155-161 Medicina Interna; Vol. 13 N.º 3 (2006): Julho/ Setembro; 155-161 2183-9980 0872-671X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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