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Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria

Background and objectives: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients. Ma...

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Autores principales: Naydenov, Stefan, Runev, Nikolay, Manov, Emil, Vasileva, Daniela, Rangelov, Yavor, Naydenova, Nadya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122103/
https://www.ncbi.nlm.nih.gov/pubmed/30344265
http://dx.doi.org/10.3390/medicina54030034
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author Naydenov, Stefan
Runev, Nikolay
Manov, Emil
Vasileva, Daniela
Rangelov, Yavor
Naydenova, Nadya
author_facet Naydenov, Stefan
Runev, Nikolay
Manov, Emil
Vasileva, Daniela
Rangelov, Yavor
Naydenova, Nadya
author_sort Naydenov, Stefan
collection PubMed
description Background and objectives: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients. Materials and Methods: A cross-sectional study including 1027 consecutive patients (n = 516, 50.2% males) with a mean age of 67.6 ± 11.3 years, hospitalized for any reason from 1 May until 31 December 2016 in one of the largest internal clinics in Bulgaria, was carried out. Results: Atrial fibrillation was diagnosed in 634 (61.7%) patients. The prevalence of modifiable AF risk factors was as follows: heart failure, 98.9%; arterial hypertension (HTN), 93.5%; valvular heart disease, 40.9%; chronic lung disease, 26.7%; type 2 diabetes mellitus, 24.9%; thyroid disease, 16.9%; and ischemic heart disease, 11.2%. Univariate logistic regression analysis identified the following risk factors with strongest impact on AF: left ventricular ejection fraction <40% (odds ratio (OR) = 1.951, 95% confidence interval (CI) 1.208–3.151), valvular heart disease (OR = 1.926, 95% CI 1.134–3.862), left ventricular ejection fraction 40–49% (OR = 1.743, 95% CI 1.248–3.017), HTN (OR = 1.653, 95% CI 1.092–3.458). History of ischemic stroke was present in 14.4% of the patients with AF. Oral antithrombotic drugs were prescribed to 85.7%: direct oral anticoagulants to 37.9%, vitamin K antagonists to 43.2%, and antiplatelets to 4.6%. Heart rate control medications and antiarrhythmics were prescribed to 75.4% and 40.2%, respectively. Conclusions: Atrial fibrillation was highly prevalent among our study population. Reduced and mid-range left ventricular ejection fraction, valvular heart disease, and HTN were the risk factors with the strongest association with AF. Although a large number of our AF patients were administered antithrombotic treatment, the prescription rate of oral anticoagulants should be further improved.
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spelling pubmed-61221032018-10-18 Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria Naydenov, Stefan Runev, Nikolay Manov, Emil Vasileva, Daniela Rangelov, Yavor Naydenova, Nadya Medicina (Kaunas) Article Background and objectives: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients. Materials and Methods: A cross-sectional study including 1027 consecutive patients (n = 516, 50.2% males) with a mean age of 67.6 ± 11.3 years, hospitalized for any reason from 1 May until 31 December 2016 in one of the largest internal clinics in Bulgaria, was carried out. Results: Atrial fibrillation was diagnosed in 634 (61.7%) patients. The prevalence of modifiable AF risk factors was as follows: heart failure, 98.9%; arterial hypertension (HTN), 93.5%; valvular heart disease, 40.9%; chronic lung disease, 26.7%; type 2 diabetes mellitus, 24.9%; thyroid disease, 16.9%; and ischemic heart disease, 11.2%. Univariate logistic regression analysis identified the following risk factors with strongest impact on AF: left ventricular ejection fraction <40% (odds ratio (OR) = 1.951, 95% confidence interval (CI) 1.208–3.151), valvular heart disease (OR = 1.926, 95% CI 1.134–3.862), left ventricular ejection fraction 40–49% (OR = 1.743, 95% CI 1.248–3.017), HTN (OR = 1.653, 95% CI 1.092–3.458). History of ischemic stroke was present in 14.4% of the patients with AF. Oral antithrombotic drugs were prescribed to 85.7%: direct oral anticoagulants to 37.9%, vitamin K antagonists to 43.2%, and antiplatelets to 4.6%. Heart rate control medications and antiarrhythmics were prescribed to 75.4% and 40.2%, respectively. Conclusions: Atrial fibrillation was highly prevalent among our study population. Reduced and mid-range left ventricular ejection fraction, valvular heart disease, and HTN were the risk factors with the strongest association with AF. Although a large number of our AF patients were administered antithrombotic treatment, the prescription rate of oral anticoagulants should be further improved. MDPI 2018-05-25 /pmc/articles/PMC6122103/ /pubmed/30344265 http://dx.doi.org/10.3390/medicina54030034 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Naydenov, Stefan
Runev, Nikolay
Manov, Emil
Vasileva, Daniela
Rangelov, Yavor
Naydenova, Nadya
Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title_full Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title_fullStr Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title_full_unstemmed Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title_short Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria
title_sort risk factors, co-morbidities and treatment of in-hospital patients with atrial fibrillation in bulgaria
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122103/
https://www.ncbi.nlm.nih.gov/pubmed/30344265
http://dx.doi.org/10.3390/medicina54030034
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