Clinical Profile and One Year Outcome of Atrial Fibrillation- A Prospective Cohort Study
Introduction: Atrial Fibrillation (AF) is the most common arrhythmia in clinical practice and imposes a great burden on health care resources. There is limited data regarding the impact of AF in our population. Aim: To estimate the mortality and Major adverse Cardiovascular events {(MACE)- Acut...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/14023/45478_CE[Ra1]_F(SL)_PF1(AB_SL)_PFA(SL)_PN(SL).pdf |
| Summary: | Introduction: Atrial Fibrillation (AF) is the most common
arrhythmia in clinical practice and imposes a great burden on
health care resources. There is limited data regarding the impact
of AF in our population.
Aim: To estimate the mortality and Major adverse Cardiovascular
events {(MACE)- Acute Coronary Syndrome (ACS), Stroke,
Cardiac death} in AF patients in a tertiary care centre in
South India.
Materials and Methods: This prospective cohort study
included all patients >18 years with newly diagnosed or
previously documented evidence of AF in Electrocardiography
(ECG). Transient reversible causes and critically ill patients were
excluded. Total of 346 patients were recruited and prospectively,
followed-up at 1, 3, 6 and 12 months for development of MACE,
anticoagulation status, Prothrombin Time (PT), International
Normalised Ratio (INR) and major bleeding events. Baseline data
including clinical parameters, comorbidities and appropriate
investigations such as ECG and Echocardiogram (ECHO)
parameters were collected with a structured questionnaire and
analysed at one year using appropriate statistical tests.
Results: Average age was 60.5 years (SD 11.5 years) and
majority (74.6%) were between 50-75 years. Females were
more (59.5% vs 40.5%). Most common AF risk factor was
Hypertension (44.5%) followed by Rheumatic Heart Disease
(RHD) in 27.2% of AF patients. AF was classified as permanent
in 42.2%, persistent in 23.1% and paroxysmal in 34.7%.
Valvular AF was present in 26.6% and non-valvular AF in 73.4%.
At one year, 17 patients were lost to follow-up. CHA2
DS2
VASc
score of ≥2 was present in 65.1%. During one year follow-up
the MACE rate was 26.7% (ischemic stroke in 9.4%, ACS in
2.7% and cardiac mortality in 14.6 %). Mean time in Therapeutic
Range (TTR) was 28.12%. TTR >60% (good control) was present
in only 9.2%.
Conclusion: AF continues to be a significant arrhythmia causing
substantial morbidity and mortality. Non-valvular AF was
thrice as common as valvular AF. Though 3/4th of the patients
were on oral anticoagulants, <10% had their INR under good
control which contributed to the higher events. To improve the
outcomes in AF patients, treatment of risk factors and optimal
anticoagulation plays a crucial role. |
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| ISSN: | 2249-782X 0973-709X |