Adecuación del tratamiento antitrombótico en los pacientes con fibrilación auricular no valvular. Registro AFINVA

OBJECTIVE: To determine whether antithrombotic treatment (ATT) in patients with non-valvular atrial fibrillation in a health area complies with the recommendations of current clinical guidelines. DESIGN: Prospective observational study. LOCATION: Primary Health Care Centres and Cardiology Department of a Health Department of the Valencian Community, Spain. PARTICIPANTS: A total of 505 patients with nonvalvular atrial fibrillation were included in the study. MAIN MEASUREMENTS: ATT was deemed to be inappropriate in patients with a CHA(2)DS(2)-VASc score ≥ 1 and who were not under oral anticoagulation, in patients treated with antivitamin K drugs, and poor control of oral anticoagulation, or with antiplatelet therapy inappropriately associated with anticoagulation, and in patients on ATT with a CHA(2)DS(2)-VASc score = 0. RESULTS: The median age was 77.4 ± 10 years. The ATT was considered inadequate in 58% of cases. Factors independently associated with inadequate ATT were age (OR: 1.02 [1-1.04]; P = .029), hypothyroidism (OR: 1.98 [1.14-3.43]; P = .015), ischaemic heart disease (OR: 1.3 [1.15-2.59]; P = .008) and paroxysmal non-valvular AF (OR: 2.11 [1.41-3.17]; P < .0001). CONCLUSIONS: These data underline the high prevalence of inadequate ATT in daily practice, as well its different causes.