PATIENTS WITH ATRIAL FIBRILLATION IN MULTIDISCIPLINARY HOSPITAL: STRUCTURE OF HOSPITALIZATION, CONCOMITANT CARDIOVASCULAR DISEASES AND DRUG TREATMENT (DATA OF RECVASA AF-TULA REGISTRY)

Aim. To determine the proportion of patients with atrial fibrillation (AF) among hospitalized patients in the departments of the multidisciplinary hospital and to study the structure of the associated cardiovascular diseases (CVD) and drug therapy within the RECVAZA AF-Tula hospital registry.

Material and methods. All patients with a diagnosis of AF in the patient's chart (n=1225) were included into the RECVAZA AF-Tula registry; that is 4.2% of 29018 patients hospitalized to the Tula Regional Clinical Hospital in 2013. The structure of the associated cardiovascular diseases, as well as drug therapy, was evaluated on the basis of data in the medical documentation.

Results. The mean age of patients with AF was 69.6±9.9 years, men was 47.8%. 87.5% of patients had a combination of AF with hypertension, 75.1% – with ischemic heart disease, and 81.4% – with chronic heart failure. The average number of diagnoses was 3.4 per patient. The proportion of patients with permanent, persistent and paroxysmal forms of AF was 46.4%, 20%, and 29%, respectively. The risk score according to the CHA2DS2-VASc and HAS-BLED scales was higher in patients of therapeutic profile (4.27±1.66 and 1.48±0.95) than this in patients of surgical profile (3.57±1.70 and 1.06±0.74, p<0.05). Average number of medicines for the treatment of cardiovascular diseases was 4.8. The frequency of prognostically significant drug prescriptions for CVD increased in hospital, in comparison with the outpatient stage, by an average of 1.2 times. Frequency of prescribing prognostically significant medications at discharge was higher in the therapeutic departments than this in the surgical departments (77.0% vs 57.1%, p<0.0001), including anticoagulants (65.8% vs 48.3%, p<0.0001). The frequency of compliance of drug prescriptions with clinical guidelines in the hospital was insufficient (on average 67.6%); whereas in the cardiology group of departments it was significantly higher than this in departments of other profiles.

Conclusion. Patients with AF accounted for 4.2% of all hospitalized patients in a multidisciplinary hospital. The proportion of patients with AF in the therapeutical departments was 4 times more than that in the surgical departments. Most patients enrolled in the registry had associated CVD. The compliance of drug therapy of CVD to clinical guidelines was insufficient, especially at the outpatient stage, as well as in the surgical departments of the hospital. 

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