Atrial Fibrillation: from the guidelines to the reality

Detalhes bibliográficos
Autor(a) principal: Costa Reis, Patrícia
Data de Publicação: 2006
Outros Autores: Patrícia, Tereza, Dutschmann, Luís
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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spelling 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
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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
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