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Significant ethnic differences exist in the epidemiology of atrial fibrillation (AF). However, ethnic differences in hospitalized patients with AF are rarely reported, especially in Xinjiang. The purpose of this study was to investigate the demography profile of patients hospitalized with AF, and to compare the utilization of their maintenance antithrombotic treatment among Han and Uygur.
Used data from a retrospective descriptive study, all hospitalized patients from 13 hospitals since Jul 1, 2014 to Jun 31, 2015 in Xinjiang, China. Antithrombotic management was measured according to guideline-recommended risk scores.
A total of 4 181 cases with AF were identified at 13 sites from Jul 1, 2014 to Jun 31, 2015. mean age 69.46±11.68 years,41.4% females; 2990(71.5%) were Han and 1191 (28.5%) were Uygur. Han patients were older (mean age 71.3 vs 64.96, p<0.001). The distribution of hospitalized patients with AF is shifted towards the older age groups. Both groups exist great differences in age distribution. Hans patients were higher among 65-74 years old and Uygur were higher among 75-84 years old. Compared with Han participants, Uygur patients had higher body mass index(BMI), were more often permanent AF, and had more stroke/TIA and chronic obstructive pulmonary disease(COPD) comorbidities. Han participants had more hypertension, diabetes mellitus.
Overall, 74.2% of Han and 47.2% of Uygur were managed with a rate control strategy(p<0.001); 28.0% of Han and 13.43% Uygur were accepted rhythm control therapy((p<0.001)). Consistent with a rate and rhythm controlled strategy, Han patients underwent more prior cardioversions and prior interventional therapy for AF.
Among high risk population(CHADS2-scores ≥2), 49.5% of Han versus 70.2% Uygur were not receiving anticoagulation therapy(p<0.001). No significant differences in overtreated (44.4% vs 34.31%, p=0.25). 43.1% of Han and 43.5% of Uygur at middle risk were untreated (p=1), and 7.1% versus 4.5% were overtreated (p=0.40). At low risk of stroke (CHA2DS2-VASc =0), 55.6% Han and 65.69% receibed anticoagulant therapy, while 44.4% and 34.31 respectively received possible overtreatment(p=0.10).
This hospital-based study revealed most of all patients with AF were at high risk for stroke. Anticoagulation for AF is not prescribed in accordance with guideline recommendations. Improving better strategy to improve management of AF itself is needed.