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Baseline characteristics and management of patients with atrial fibrillation/flutter in the emergency department: results of a prospective, multicentre registry in C hina
Author(s) -
Zhang H.,
Yang Y.,
Zhu J.,
Shao X.,
Liu Y.,
Zhao L.,
Yu P.,
Zhang H.,
He Q.,
Gu X.
Publication year - 2014
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12487
Subject(s) - medicine , atrial fibrillation , emergency department , valvular heart disease , heart failure , atrial flutter , cardiology , prospective cohort study , comorbidity , stroke (engine) , concomitant , coronary artery disease , diabetes mellitus , mechanical engineering , psychiatry , engineering , endocrinology
Background/Aim There have been several studies of atrial fibrillation ( AF ) over the past decades; however, data from C hinese patients are scarce. The aim of the study was therefore to describe the patient characteristics, risk profile and management strategies for C hinese AF patients presenting to emergency department ( ED ). Methods We conducted a prospective, multicentre registry of patients with AF or atrial flutter ( AFL ) in C hina. Participants were enrolled at 20 ED s, then data regarding baseline characteristics and treatment in ED s were collected. Results Of the 2016 C hinese patients, 1104 (54.8%) were female. Six hundred eighteen (30.7%) had paroxysmal AF , 452 (22.4%) had persistent AF and 945 (46.9%) had permanent AF . The most common comorbidity was hypertension (55.5%), followed by coronary artery disease (41.8%) and heart failure ( HF , 37.4%). The prevalence of concomitant cardiovascular risk factors, such as HF and valvular heart disease, increased as AF progressed. Among the patients with non‐valvular AF , 110 (12.7%) of those with CHADS 2 (congestive HF , hypertension, age of 75 years and greater, diabetes mellitus and history of stroke) ≥2 were prescribed oral anticoagulants ( OAC ), while 119 (15.6%) of those with CHADS 2 <2 received such agents. Among the 324 patients with valvular AF , 134 (41.4%) actually were treated with OAC . The international normalised ratio value was within the target range (2.0–3.0) in 96 patients only (26.4%). Moreover, a total of 16.2% of the patients received ≥1 anti‐arrhythmic agents, whereas rate control agents were used more frequently (68.4%). Conclusions According to the present study, the risk profile and management of C hinese patients with AF / AFL differed from that observed in previous studies. The use of OAC inadequately deviate from current guidelines.