title: Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: the ATA AF study.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with a high risk of stroke and mortality.
  
  
  OBJECTIVE
  To describe the difference in AF management of patients (pts) referred to Cardiology (CARD) or Internal Medicine (MED) units in Italy.
  
  
  RESULTS
  From May to July 2010, 360 centers enrolled 7148 pts (54% in CARD and 46% in MED). Median age was 77 years (IQR 70-83). Hypertension was the most prevalent associated condition, followed by hypercholesterolemia (28.9%), heart failure (27.7%) and diabetes (24.3%). MED pts were older, more frequently females and more often with comorbidities than CARD pts. In the 4845 pts with nonvalvular AF, a CHADS2 score ≥ 2 was present in 53.0% of CARD vs 75.3% of MED pts (p<.0001). Oral anticoagulants (OAC) were prescribed in 64.2% of CARD vs 46.3% of MED pts (p<.0001); OAC prescription rate was 49.6% in CHADS2 0 and 56.2% in CHADS2 score ≥ 2 pts. At the adjusted analysis patients managed in MED had a significantly lower probability to be treated with OAC. Rate control strategy was pursued in 51.4% of the pts (60.5% in MED and 43.6% in CARD) while rhythm control was the choice in 39.8% of CARD vs 12.9% of MED pts (p<.0001).
  
  
  CONCLUSIONS
  Cardiologists and internists seem to manage pts with large epidemiological differences. Both CARD and MED specialists currently fail to prescribe OAC in accordance with stroke risk. Patients managed by MED specialists have a lower probability to receive an OAC treatment, irrespective of the severity of clinical conditions.
authors.affiliation: Department of Cardiology, Maggiore Hospital, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Pasquale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mathieu
authors.forename: Aldo Pietro
authors.initials: AP
authors.lastname: Maggioni
authors.forename: Gianna
authors.initials: G
authors.lastname: Fabbri
authors.forename: Donata
authors.initials: D
authors.lastname: Lucci
authors.forename: Giorgio
authors.initials: G
authors.lastname: Vescovo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pirelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarella
authors.forename: Marino
authors.initials: M
authors.lastname: Scherillo
authors.forename: Michele Massimo
authors.initials: MM
authors.lastname: Gulizia
authors.forename: Gualberto
authors.initials: G
authors.lastname: Gussoni
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Colombo
authors.forename: Domenico
authors.initials: D
authors.lastname: Panuccio
authors.forename: Carlo
authors.initials: C
authors.lastname: Nozzoli
authors.forename: Massimo Zoni
authors.initials: MZ
authors.lastname: Berisso
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016507:Cardiology Service, Hospital; D019468:Disease Management; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007388:Internal Medicine / Q000379:methods*; D007558:Italy / Q000453:epidemiology; D008297:Male
chemical_list: D005343:Fibrinolytic Agents