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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
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 observationa...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Cardiology
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711680/ https://www.ncbi.nlm.nih.gov/pubmed/29171211 http://dx.doi.org/10.4070/kcj.2017.0146 |
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author | Kim, Hyeongsoo Kim, Tae-Hoon Cha, Myung-Jin Lee, Jung Myung Park, Junbeom Park, Jin-Kyu Kang, Ki-Woon Shim, Jaemin Uhm, Jae-Sun Kim, Jun Park, Hyung Wook Choi, Eue-Keun Kim, Jin-Bae Kim, Changsoo Lee, Young Soo Joung, Boyoung |
author_facet | Kim, Hyeongsoo Kim, Tae-Hoon Cha, Myung-Jin Lee, Jung Myung Park, Junbeom Park, Jin-Kyu Kang, Ki-Woon Shim, Jaemin Uhm, Jae-Sun Kim, Jun Park, Hyung Wook Choi, Eue-Keun Kim, Jin-Bae Kim, Changsoo Lee, Young Soo Joung, Boyoung |
author_sort | Kim, Hyeongsoo |
collection | PubMed |
description | 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 CHA(2)DS(2)-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. |
format | Online Article Text |
id | pubmed-5711680 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | The Korean Society of Cardiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-57116802017-12-05 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 Kim, Hyeongsoo Kim, Tae-Hoon Cha, Myung-Jin Lee, Jung Myung Park, Junbeom Park, Jin-Kyu Kang, Ki-Woon Shim, Jaemin Uhm, Jae-Sun Kim, Jun Park, Hyung Wook Choi, Eue-Keun Kim, Jin-Bae Kim, Changsoo Lee, Young Soo Joung, Boyoung Korean Circ J Original Article 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 CHA(2)DS(2)-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. The Korean Society of Cardiology 2017-11 2017-10-17 /pmc/articles/PMC5711680/ /pubmed/29171211 http://dx.doi.org/10.4070/kcj.2017.0146 Text en Copyright © 2017. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Hyeongsoo Kim, Tae-Hoon Cha, Myung-Jin Lee, Jung Myung Park, Junbeom Park, Jin-Kyu Kang, Ki-Woon Shim, Jaemin Uhm, Jae-Sun Kim, Jun Park, Hyung Wook Choi, Eue-Keun Kim, Jin-Bae Kim, Changsoo Lee, Young Soo Joung, Boyoung 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711680/ https://www.ncbi.nlm.nih.gov/pubmed/29171211 http://dx.doi.org/10.4070/kcj.2017.0146 |
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