[Features, management and prognosis of Chilean patients with non valvular atrial fibrillation: GARFIELD AF registry]. / Características basales, manejo de terapias antitrombóticas y pronóstico de pacientes chilenos con FA no valvular. Lecciones del Registro GARFIELD AF en Chile.

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with high rates of death, ischemic stroke and systemic embolism (SE). There is scarce information about clinical characteristics and use of anti-thrombotic therapies in Chilean patients with non-valvular AF. AIM: To describe the characteristics and 1-year outcomes of patients with recently diagnosed AF recruited in Chile into the prospective global GARFIELD-AF registry. MATERIAL AND METHODS: Between 2011-2016, we prospectively registered information of 971 patients recruited at 15 centers, 85% of them from the public system and 15% from the private sector. Demographics, clinical characteristics and use of antithrombotic therapies were recorded for all patients. Adverse clinical outcomes were analyzed in 711 patients with 1-year follow-up. RESULTS: The mean age was 71.5 years (66-79), 50% were men. Mean CHAD2S2 Vasc and HAS BLED scores for stroke risk were 3.3 (2.0-4.0) and 1.5 (1.0-2.0) respectively. Oral anticoagulants were prescribed in 82% of patients. Seventy percent received Vitamin K antagonists, 10% novel direct anticoagulants or antiplatelet therapy and only 8% did not receive any antithrombotic therapy. Mean time in optimal therapeutic range (an international normalized ratio of 2 to 3), was achieved in only 40.7% (23.0-54.8) of patients receiving Vitamin K antagonists. One year rates of death, stroke/systemic embolism and bleeding were 4.75 (3.36-6.71), 2.40 (1.47-3.92) and 1.64% (0.91-2.97) per 100 person-years. Ischemic stroke occurred in 1.8% and hemorrhagic stroke in 0.8% of patients at 1-year of follow up. CONCLUSIONS: Although the use of vitamin K antagonists at baseline was high, the mean time in optimal therapeutic range was low. Mortality and stroke rates are higher than those reported in other contemporary registries.

Características basales, manejo de terapias antitrombóticas y pronóstico de pacientes chilenos con FA no valvular. Lecciones del Registro GARFIELD AF en Chile / Features, management and prognosis of Chilean patients with non valvular atrial fibrillation: GARFIELD AF registry

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with high rates of death, ischemic stroke and systemic embolism (SE). There is scarce information about clinical characteristics and use of anti-thrombotic therapies in Chilean patients with non-valvular AF. Aim: To describe the characteristics and 1-year outcomes of patients with recently diagnosed AF recruited in Chile into the prospective global GARFIELD-AF registry. Material and Methods: Between 2011-2016, we prospectively registered information of 971 patients recruited at 15 centers, 85% of them from the public system and 15% from the private sector. Demographics, clinical characteristics and use of antithrombotic therapies were recorded for all patients. Adverse clinical outcomes were analyzed in 711 patients with 1-year follow-up. Results: The mean age was 71.5 years (66-79), 50% were men. Mean CHAD2S2 Vasc and HAS BLED scores for stroke risk were 3.3 (2.0-4.0) and 1.5 (1.0-2.0) respectively. Oral anticoagulants were prescribed in 82% of patients. Seventy percent received Vitamin K antagonists, 10% novel direct anticoagulants or antiplatelet therapy and only 8% did not receive any antithrombotic therapy. Mean time in optimal therapeutic range (an international normalized ratio of 2 to 3), was achieved in only 40.7% (23.0-54.8) of patients receiving Vitamin K antagonists. One year rates of death, stroke/systemic embolism and bleeding were 4.75 (3.36-6.71), 2.40 (1.47-3.92) and 1.64% (0.91-2.97) per 100 person-years. Ischemic stroke occurred in 1.8% and hemorrhagic stroke in 0.8% of patients at 1-year of follow up. Conclusions: Although the use of vitamin K antagonists at baseline was high, the mean time in optimal therapeutic range was low. Mortality and stroke rates are higher than those reported in other contemporary registries.

[Results of the first Chilean registry of unstable angina. Clinical features, risk profile and treatment]. / Resultados del primer registro chileno de angina inestable: características clínicas, perfil de riesgo y tratamiento.

BACKGROUND: From January 2000 to June 2002, the first Chilean registry of unstable angina was carried out, with the participation of 15 hospitals. AIM: To report the clinical and demographic features of 600 patients with unstable angina, their risk profile and prognosis. MATERIAL AND METHODS: The inclusion criteria for this prospective registry were a history of recent onset of chest pain (<48 hours) or a change in the character of previous angina, associated to ischemic electrocardiographic changes and/or positive markers of myocardial damage. RESULTS: Mean age of the patients was 65 years and 37% were women. Among coronary risk factors, 63% had hypertension, 27% had diabetes, 52% had dyslipidemia, 31% smoked and 21% had a family history of atherosclerosis. On admission 94% of patients had chest pain, associated to ST segment depression in 44%, negative T waves in 28% and positive markers of myocardial damage in 30%. Fifty seven percent received intravenous nitroglycerin, 47% received oral nitrates, 69% beta blockers and 15%, calcium antagonists. Antithrombotic therapy included aspirin in 96%, heparin in 74%, ticlodipine or clopidogrel in 19% and IIb/IIIa inhibitors in 12%. A coronary angiogram was performed in 52%, angioplasty in 25% and coronary bypass surgery in 13%. Hospital mortality was 2.6%. The incidence of new ischemic events was: myocardial infarction in 2.8% recurrent ischemia in 9.5% and refractory ischemia in 2%. The incidence of adverse events increased according to a higher risk profile. CONCLUSIONS: The demographic and clinical features, treatment and mortality of these patients are similar to those reported in international registries, with a low mortality rate.