Prevalence of atrial fibrillation, oral anticoagulation prescription and associated factors in Brazilian older adults

• Autor(a) principal: Oliveira,Vitor Pelegrim de
• Data de Publicação: 2020
• Outros Autores: Mello,Renato Gorga Bandeira de, Costa,Andry Fiterman, Corte,Roberta Rigo Dalla, Flores,Francine da Rocha, Xavier,Nicóli Bertuol, Nunes,Nathália Marzotto, Moriguchi,Emilio Hideyuki
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Geriatrics, Gerontology and Aging (Online)
• Texto Completo: https://ggaging.com/details/1652
• topic: atrial fibrillation; anticoagulants; prevalence; geriatrics; cerebral infarction.

<p><b>INTRODUCTION:</b> Atrial fibrillation increases five times the risk of stroke. Anticoagulation reduces the incidence of cerebrovascular events. However, many patients do not receive thromboprophylaxis.<br> <b>OBJECTIVES:</b> To estimate the prevalence of atrial fibrillation in the older patients at a Brazilian university hospital and the proportion of anticoagulation prescription. Secondary objectives were to identify the therapeutic options, the main reasons for non-prescription and the factors associated with ineffectiveness or lack of treatment.<br> <b>METHODS:</b> This was a cross-sectional study with a consecutive sample of 1,630 outpatients selected at Hospital de Clínicas de Porto Alegre between April and June of 2017. Atrial fibrillation was identified in 220 (13.50%) individuals. <b>t</b> Medical records from 145 patients were accessed, followed by a telephone interview. The association between variables and “ outcomes was checked using the Mann-Whitney’s U Test and a chi-squared test.<br> <b>RESULTS:</b> The prevalence of atrial fibrillation was 13.50%. Anticoagulation therapy was prescribed in 77.93% of cases. In 76.11% of patients, warfarin was the chosen drug. &lt; There was a tendency towards no prescription in patients with previous bleeding (RR = 2.32; 95%CI 0.95 - 5.64; p = 0.06) and falls (RR = 2.02; 95%CI 0.82 - 5.03; p = 0.08). We found an association between reduced functional capacity (Barthel’s Activities of Daily Living Score &lt; 80) and higher rate of anticoagulation in therapeutic target (RR = 0.22; 95%CI 0.06 - 0.87; p = 0.04).<br> <b>CONCLUSION:</b> The prevalence of atrial fibrillation in this population was 13.50% and in 77.93% of cases anticoagulant were prescribed. Functional impairment was associated with a higher rate of anticoagulation in therapeutic target.</p>