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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
- 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
- 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; Kim, Hyeongsoo; Kim, Tae-Hoon; Cha, Myung-Jin; Lee, Jung Myung; Park, Junbeom
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- KOREAN CIRCULATION JOURNAL
- 1738-5520; 1738-5555
- vol. 47, no. 6, pp. 877 - 887
- Atrial fibrillation; Anticoagulant agent; Guidelines adherence; Registry
- KOREAN SOC CARDIOLOGY
- SCIE; SCOPUS; KCI
- 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%), ss-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.
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