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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)

https://doi.org/10.20996/1819-6446-2014-10-4-366-377

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Abstract

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.

About the Authors

M. M. Loukianov
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Leading Researcher of Department of Clinical Cardiology and Molecular Genetics

Petroverigsky per. 10, Moscow, 101990 Russia



S. A. Boytsov
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Professor, Head of the same Department, Director

Petroverigsky per. 10, Moscow, 101990 Russia



S. S. Yakushin
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

MD, PhD, Professor, Head of Chair of Hospital Therapy

Visokovoltnaya ul. 9, Ryazan, 390026 Russia



S. Yu. Martsevich
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy

Petroverigsky per. 10, Moscow, 101990 Russia



A. N. Vorobyev
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

MD, PhD, Assistant of Chair of Hospital Therapy

Visokovoltnaya ul. 9, Ryazan, 390026 Russia



A. V. Zagrebelnyy
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Senior Researcher of Department of Preventive Pharmacotherapy

Petroverigsky per. 10, Moscow, 101990 Russia



M. S. Kharlap
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Senior Researcher of Department of Clinical Cardiology and Molecular Genetics

Petroverigsky per. 10, Moscow, 101990 Russia



K. G. Pereverzeva
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

MD, PhD student of Chair of Hospital Therapy

Visokovoltnaya ul. 9, Ryazan, 390026 Russia



E. A. Pravkina
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation

MD, PhD student of the same chair

Visokovoltnaya ul. 9, Ryazan, 390026 Russia



S. E. Serdyuk
State Research Center for Preventive Medicine
Russian Federation

MD, PhD, Senior Researcher of Department of Clinical Cardiology and Molecular Genetics

Petroverigsky per. 10, Moscow, 101990 Russia



A. D. Deev
State Research Center for Preventive Medicine
Russian Federation

PhD, Head of Laboratory of Biostatistics

Petroverigsky per. 10, Moscow, 101990 Russia



E. N. Kudryashov
State Research Center for Preventive Medicine
Russian Federation

Programmer of the same laboratory

Petroverigsky per. 10, Moscow, 101990 Russia



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For citation:


Loukianov M.M., Boytsov S.A., Yakushin S.S., Martsevich S.Yu., Vorobyev A.N., Zagrebelnyy A.V., Kharlap M.S., Pereverzeva K.G., Pravkina E.A., Serdyuk S.E., Deev A.D., Kudryashov E.N. 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). Rational Pharmacotherapy in Cardiology. 2014;10(4):366-377. https://doi.org/10.20996/1819-6446-2014-10-4-366-377

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)