Preview

Rational Pharmacotherapy in Cardiology

Advanced search

Changes in Prescribing Antithrombotic Therapy in Patients with Atrial Fibrillation in the Multidisciplinary Hospital in Volgograd from 2012 to 2020

https://doi.org/10.20996/1819-6446-2021-12-06

Full Text:

Abstract

Aim. To study the frequency of prescribing antithrombotic agents in patients with non-valvular atrial fibrillation (AF) in real clinical practice, to evaluate changes of prescriptions from 2012 till 2020.

Material and methods. The medical records of inpatients (Form 003/y) with the diagnosis AF, hospitalized in the cardiological department were analyzed. According to the inclusion criteria, the patients were over 18 years of age, established diagnosis of non-valvular AF. There were two exclusion criteria: congenital and acquired valvular heart disease and prosthetic heart valves. In retrospective analysis we have included 263 case histories in 2012, 502 ones in 2016 and 524 in 2020. CHA2DS2-VASc score was used for individual stroke risk assessment in AF. The rational use of the antithrombotic therapy was evaluated according with current clinical practice guidelines at analyzing moment.

Results. During period of observation the frequency of antiplatelet therapy significantly decreased from 25,5% to 5,5% (р<0.001), decreased the frequency of administration of warfarin from 71,9% to 18,3% (р<0.001). The frequency of use of direct oral anticoagulants increased in 2020 compared to 2016 (р<0.001). For patients with a high risk of stroke anticoagulant therapy was administered in 71.8% of cases in 2012, 88.5% in 2016 and 92.5% in 2020. Before discharge from hospital majority of patients (72%) achieved a desired minimum international normalized ratio (INR) from 2.0 to 3.0 in 2012. In 2016 and 2020 an only 33% and 40.6% of patients achieved INR (2.0-3.0).

Conclusion. Doctors have become more committed to following clinical guidelines during the period of the investigation. In 2020 antithrombotic therapy for atrial fibrillation was suitable according to current clinical guidelines.

About the Authors

A. S. Gerasimenko
Volgograd State Medical University
Russian Federation

Anastasia S.Gerasimenko.

Volgograd.

eLibrary SPIN 5800-2710



O. V. Shatalova
Volgograd State Medical University
Russian Federation

Olga V. Shatalova.

Volgograd.

eLibrary SPIN 3783-6286



V. S. Gorbatenko
Volgograd State Medical University
Russian Federation

Vladislav S. Gorbatenko.

Volgograd.

eLibrary SPIN 6486-9110



V. I. Petrov
Volgograd State Medical University
Russian Federation

Vladimir I. Petrov.

Volgograd.

eLibrary SPIN 2224-5311



References

1. Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):373-498. DOI:10.1093/eurheartj/ehaa612.

2. Petersen P, Godtfredsen J, Boysen G, et al. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. Lancet. 1989;333(8631):175-9. DOI:10.1016/s0140-6736(89)91200-2.

3. Camm AJ, Kirchhof P, Lip GYH, et al. Guidelines for the management of atrial fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369-429. DOI:10.1093/eurheartj/ehq278.

4. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893-962. DOI:10.1093/eurheartj/ehw210.

5. Diagnosis and treatment of atrial fibrillation. Russian guidelines (2011). Rational Pharmacotherapy in Cardiology. 2011;7(4):5-80 (In Russ.) DOI:10.20996/1819-6446-2011-7-4.

6. Diagnosis and treatment of atrial fibrillation. Clinical Guidelines (2017) [cited 2021 Jul 18]. Available from: https://vnoa.ru/upload/iblock/552/552a2e66b804a65431f406f5da4545ba.pdf

7. Cullen MW, Kim S, Piccini JP, et al. Risks and Benefits of Anticoagulation in Atrial Fibrillation. Circ Cardiovasc Qual Outcomes. 2013;6(4):461-9. DOI:10.1161/CIRCOUTCOMES.113.000127.

8. Boriani G, Proietti M, Laroche C, et al. Association between antithrombotic treatment and outcomes at 1-year follow-up in patients with atrial fibrillation: the EORP-AF General Long-Term Registry. Europace. 2019;21(7):1013-22. DOI:10.1093/europace/euz032.

9. Loukianov MM, Boytsov SA, Yakushin SS, et al. 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):366-77 (In Russ.) DOI:10.20996/1819-6446-2014-10-4-366-377.

10. Gaisenok OV, Leonov AS. The use of oral anticoagulants in patients with atrial fibrillation: cohort study data. Rational Pharmacotherapy in Cardiology. 2016;12(4):376-79 (In Russ.) DOI:10.20996/1819-6446-2016-12-4-376-379.

11. Bassand JP, Apenteng PN, Atar D, et al. GARFIELD-AF: a worldwide prospective registry of patients with atrial fibrillation at risk of stroke. Future Cardiol. 2021;17(1):19-38. DOI:10.2217/fca-2020-0014.

12. Petrov VI, Shatalova OV, Maslakov AS. Analysis of antithrombotic therapy in in-patients with permanent atrial fibrillation (pharmacoepidemiology study). Rational Pharmacotherapy in Cardiology. 2014;10(2):174-8 (In Russ.) DOI:10.20996/1819-6446-2014-10-2-174-178.

13. Petrov VI, Shatalova OV, Gerasimenko AS, Gorbatenko VS. Comparative Analysis of Antithrombotic Therapy in In-Patients with Atrial Fibrillation. Rational Pharmacotherapy in Cardiology. 2019;15(1):49-53 (In Russ.) DOI:10.20996/1819-6446-2019-15-1-49-53.

14. Reshetko OV, Sokolov AV, Furman NV, Agapov VV. Changes in Antithrombotic Therapy of Atrial Fibrillation in the Hospital in 2011-2012 and 2016-2017 (Pharmacoepidemiological Analysis). Rational Pharmacotherapy in Cardiology. 2020;16(5):686-92 (In Russ.) DOI:10.20996/1819-6446-2020-10-10.

15. Martsevich SYu, Navasardian AR, Kutishenko NP, et al. The evaluation of antithrombotic treatment prescription dynamics in patients with atrial fibrillation by the data of PROFILE registry. Cardiovascular Therapy and Prevention. 2015;14(1):35-40 (In Russ.) DOI:10.15829/1728-8800-2015-1-35-40.

16. Melehov AV, Gendlin GE, Dadashova EF, et al. The dynamics of application of anti-thrombotic in patients fibrillation of atriums: original data and review of national registers. Medical Journal of the Russian Federation. 2017;23(3):116-26 (In Russ.) DOI:10.18821/0869-2106-2017-23-3-116-126.

17. Tuchkov AA, Gogolashvili NG, Yaskevich RA. Assessment of Antithrombotic Therapy in Patients with Atrial Fibrillation for 2015-2017 According to the Registry of the Clinic of the Scientific Research Institute of Medical Problems of the North of Krasnoyarsk City. Rational Pharmacotherapy in Cardiology. 2019;15(1):43-8 (In Russ.) DOI:10.20996/1819-6446-2019-15-1-43-48.

18. Novikova TN, Ashurov AB, Kiseleva MV, et al. Stroke Prevention in Patients with Atrial Fibrillation in Real Clinical Practice, Emphasis on Efficacy and Safety of Anticoagulant Therapy. Kardiologiia. 2020;60(4):54-61 (In Russ.) DOI:10.18087/cardio.2020.4.n1023.


Review

For citation:


Gerasimenko A.S., Shatalova O.V., Gorbatenko V.S., Petrov V.I. Changes in Prescribing Antithrombotic Therapy in Patients with Atrial Fibrillation in the Multidisciplinary Hospital in Volgograd from 2012 to 2020. Rational Pharmacotherapy in Cardiology. 2021;17(6):831-836. (In Russ.) https://doi.org/10.20996/1819-6446-2021-12-06

Views: 100


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


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