A Prospective Survey of Atrial Fibrillation Management for Real-world Guideline Adherence: COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) Registry
Korean Circulation Journal
;
: 877-887, 2017.
Article
in English
| WPRIM
| ID: wpr-90206
ABSTRACT
BACKGROUND AND OBJECTIVES:
The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment.METHODS:
In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea.RESULTS:
The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (< 40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction.CONCLUSION:
This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Asia
/
Atrial Fibrillation
/
Sotalol
/
Aging
/
Calcium Channels
/
Public Health
/
Prospective Studies
/
Guideline Adherence
/
Stroke
/
Digoxin
Type of study:
Diagnostic study
/
Practice guideline
/
Observational study
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
Korean Circulation Journal
Year:
2017
Type:
Article
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