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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

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
Authors
Kim, HyeongsooKim, Tae-HoonCha, Myung-JinLee, Jung MyungPark, JunbeomPark, Jin-KyuKang, Ki-WoonShim, JaeminUhm, Jae-SunKim, JunPark, Hyung WookChoi, Eue-KeunKim, Jin-BaeKim, ChangsooLee, Young SooJoung, Boyoung
Ewha Authors
박준범
SCOPUS Author ID
박준범scopus
Issue Date
2017
Journal Title
KOREAN CIRCULATION JOURNAL
ISSN
1738-5520JCR Link1738-5555JCR Link
Citation
vol. 47, no. 6, pp. 877 - 887
Keywords
Atrial fibrillationAnticoagulant agentGuidelines adherenceRegistry
Publisher
KOREAN SOC CARDIOLOGY
Indexed
SCIE; SCOPUS; KCI WOS
Abstract
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.
DOI
10.4070/kcj.2017.0146
Appears in Collections:
의과대학 > 의학과 > Journal papers
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