Рациональная фармакотерапия в кардиологии (Sep 2015)

DIAGNOSTICS, TREATMENT, ASSOCIATED CARDIOVASCULAR AND CONCOMITANT NON-CARDIAC DISEASES IN PATIENTS WITH DIAGNOSIS OF “ATRIAL FIBRILLATION” IN REAL OUTPATIENT PRACTICE (ACCORDING TO DATA OF REGISTRY OF CARDIOVASCULAR DISEASES, RECVASA)

  • M. M. Loukianov,
  • S. A. Boytsov,
  • S. S. Yakushin,
  • S. Yu. Martsevich,
  • A. N. Vorobyev,
  • A. V. Zagrebelnyy,
  • M. S. Kharlap,
  • K. G. Pereverzeva,
  • E. A. Pravkina,
  • S. E. Serdyuk,
  • A. D. Deev,
  • E. N. Kudryashov

DOI
https://doi.org/10.20996/1819-6446-2014-10-4-366-377
Journal volume & issue
Vol. 10, no. 4
pp. 366 – 377

Abstract

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Aim. To study the structure of risk factors and associated cardiovascular and concomitant non-cardiac diseases in patients with atrial fibrillation (AF) on the base of the data of registry, and to estimate diagnostics and treatment quality in real outpatient practice in the Ryazan region with high cardiovascular mortality rate.Material and methods. A total of 3690 patients with AF, arterial hypertension (HT), ischemic heart disease (IHD) and chronic heart failure (CHF) consulted by general practitioners and cardiologists in three outpatient clinics of Ryazan, were enrolled into the outpatient REgistry of CardioVAScular diseAses (RECVASA). 530 of 3690 (14.4%) patients had the "atrial fibrillation" diagnosis in their outpatient charts: 175 (33.0%) men, 355 (67.0%) women, and mean age – 72.3±10.1 years.Results. Permanent, paroxysmal or persistent forms of AF were indicated in outpatient charts of 43.2%, 26.4% and 24.7% of 530 AF patients, respectively, and 5.7% of outpatient charts did not specify AF form. All the AF patients had associated cardiovascular diseases (HT and/or IHD and/or CHF). The history of myocardial infarction, stroke and diabetes was revealed in 20.2%, 14.9% and 21.1% of patients, respectively. Revealed level of diagnostics did not satisfy adequate standard of examination with such cardiac pathology. Prescription of necessary drugs of some groups was insufficient, although indications existed. At the time of being included into the registry only 15.2% of AF patients received cardio-vascular drugs at a privileged price compared to 39.2% in the preceding years (p<0.05). AF diagnosis was confirmed in 84.2% of 76 randomly selected patients at its validation.Conclusion. The RECVASA research revealed high incidence of cardiac comorbidity in patients with the AF, underestimation of cardiovascular risk factors, insufficient use of diagnostic tests and prescription of some drug groups recommended by national and international guidelines.

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