[Prevention of thromboembolism in patients with chronic atrial fibrillation in primary health care].
OBJECTIVE
Our goal was to evaluate the appropriateness of antithrombotic treatment administration in patients with chronic atrial fibrillation (CAF) attended in a health primary center.


METHODS
Transverse and descriptive study; 416 patients diagnosed with CAF were included out of a population of 28,447. Age, sex, embolism risk factors, antithrombotic therapy, contraindications to anticoagulation and stratification risk variables were collected. After a bivariate analysis, a logistic regression model was done to analyze the variable associated with an incorrect antithrombotic therapy.


RESULTS
81% patients were given a correct antithrombotic therapy: 96.8% with a valvular-CAF pattern and 78.2% with a non-valvular CAF pattern. Older the patient, higher the percentage of incorrect antithrombotic administration (t = 3.184; p = 0.002). A greater embolic risk was associated with a better antithrombotic treatment (p < 0.001). The existence of at least one risk factor was also associated with a correct administration (p < 0.001). Hypertension, mitral valvular heart disease and valvular prosthesis were factors associated with a correct antithrombotic therapy. In a multivariate analysis, limited quality of life, mitral valvular heart disease, hypertension and previous systemic embolism behaved all as protective factors of a wrong treatment. An age older than 80 years was associated with a risk of treatment which was 2.89 times higher than that of individuals with the same age or youngers (OR = 2.89; 95% CI, 1.68-4.95).


CONCLUSIONS
Most patients with CAF, both valvular and non-valvular, were properly given antithrombotic therapy. The main factor associated with an incorrect antithrombotic therapy was advanced age.
Martín Acicoya
Diego
D
EAP Las Calesas. Area 11 de Madrid. Madrid. Spain.
Pedrero Pérez
Pelayo
P
Martínez García
José Antonio
JA
González Alvaro
Alberto
A
Hernando López
Teresa
T
Herreros Hernanz
Isabel
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D013030:Spain; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants