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Atrial fibrillation (AF) is the most prevalent permanent rhythm disturbance. For the diagnosis and treatment of AF numerous guidelines have been published. The data about implementation of risk calculation table (CHA2DS2-VASC score) which was suggested by European Society of Cardiology (ESC) for prevention of stroke is very limited. Our aim was to document the data about implementation of guidelines and CHA2DS2-VASC score in AF treatment by cardiology specialists.
The patients who had been following up with diagnosis of AF admitted to cardiology outpatient units, retrospectively were included into present study in 2012. With registration of clinical and demographic properties of patients CHA2DS2-VASC scores and treatment applications were investigated. According to the result of International Normalized Ratio (INR) workup at last 1 year, the success of anticoagulant therapy was evaluated.
In the year of 2012 among 2303 patients who were admitted to cardiology outpatient clinic, 137 (6.2%) patients were diagnosed with AF. Of 128 patients that were recruited to study, 83 (64.8%) were women. Mean age was 67,5±10,9 years. Mean CHA2DS2-VASC score was found 3,36±1,77. Among 108 patients whose CHA2DS2-VASC was ≥2 and who have to use anticoagulant therapy, 71 (65.7%) patients were using warfarine and 1 (0.9%) was using rivoraxaban. Sixty six patients (51.6%) were using acetylsalicilic acid. Even though warfarine was initiated, discontinuation rate of treatment was 10.2%. According to retrospective evaluation of INR levels, it was seen that in 71.1% of patients theraupetic targets were established.
Data of patients who were following up and treated with diagnosis of AF in cardiology outpatient clinic showed that ESC guidelines were taken into consideration, but difficulty in follow up of warfarine efficacy and concerns about drug-food interactions lead important number of patients not to use oral anticoagulation, but instead lead them to use acetilysalicilic acid in higher rates of guideline suggestions.