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Int J Cardiol. 2013 Sep 10;167(6):2895-903. doi: 10.1016/j.ijcard.2012.07.019. Epub 2012 Aug 11.

Current presentation and management of 7148 patients with atrial fibrillation in cardiology and internal medicine hospital centers: the ATA AF study.

Collaborators (450)

Siciliano R, Boffa M, Bazzanini F, Di Nucci G, Fonti S, De Franceschi T, Davio P, Alagna G, Cipollini F, Arma P, Gunnellini MG, Dottori M, Paulillo D, Giudice M, Sicuro M, Lenti S, Iannelli G, Notarstefano P, Galiotto M, Apolloni E, Molini G, Massarelli L, Di Iorio P, Scandurra F, Candelmo F, Iodice P, Laureano R, Perlangeli S, Praticò A, Lucchesi Q, Conese V, Scalera G, Palma F, De Antoni ME, Beltramello G, Carbonella M, Capone A, Zerella F, Masina M, Boggian G, Pancaldi LG, Brucato AL, Scialfa S, Ferrari P, Gavazzi A, Santoro E, Bertinieri G, Caragnano V, Zaccaroni S, Marchetti G, Urbinati S, Belmonte G, Giannoni C, Panuccio D, Pedone V, Colletta M, Di Pasquale G, Cemin R, Paffoni PR, Pezzotti C, Capretti M, Lamari AL, Maugeri S, Moretti R, Brotzu-S G, Ganga R, Brotzu-S G, Mascia P, Caddori A, Cusumano S, Alletto M, De Vincenzo C, Musacchio E, Stendardo A, Cantarella SA, Ferrari V, Bassano F, Perrone C, Piccinni GC, Catanzaro M, Vinciguerra A, Lusiani L, De Caro G, Scarcia M, Scarcia A, Losi E, Gaddi O, Lo A, Cascio N, Vignai E, Romano M, Borzì V, Bellanuova IA, Felis S, Gulizia MM, Francese GM, Rodolico G, Artale S, Mazzuca S, Perticone F, Tirotta D, Talini E, Ventrella F, Iosa G, Cuccurullo O, Bertello PD, Benemio G, Garognoli O, Arcelli G, Prosciutti L, De G, Franco A, Pastorelli R, Acquati F, Botto GL, Sitta N, Migliacci R, Cosmi F, Tarquini B, Chiappetta P, Sprovieri MF, Bertolazzi S, Spotti A, Pirelli S, Marasco MF, Elia M, Gambino GM, Fenoglio L, Gelmini GP, Ziacchi V, Rigon N, Petix NR, Zipoli A, Caiolo A, Marino E, Scattolin G, Gerini S, Parisi G, Tavernese G, Conti A, Ferrante F, Morettini A, Alterini B, Rocchi F, Nozzoli C, Nuova SM, Goedecke L, Nuova SM, Seravalle C, Nuova SM, Cuomo A, Panettieri I, Pellegrino P, Di Biase M, Savarese G, Patriarchi F, Bondi G, Rossini E, Nello S, Ranieri AT, Gelonesi FN, Costantini M, Dugnani M, Ria L, Mussardo V, Zanini G, Morgante O, Fazio G, Lo Pinto G, Castello C, Moroni LA, Costa S, Domenicucci S, Venzano C, Loiacono L, Ortuso R, Esposito L, Cuzzucrea DG, Fiammengo F, Selva E, Gestra R, Alessandri M, Nuzzi G, Porrino L, Parise P, Capponi EA, Mandorla S, Politi C, Olivieri C, Gurioli L, Agostinelli P, Striuli R, Petrarca M, Corsini F, Orlandini F, Badolati S, Colarusso D, Vertullo V, Pelaggi P, Campagna G, Haupt E, Parente F, Milanese G, Magliari F, Morando G, Guarise P, Mazzone A, Palumbo G, Lambelet P, Camaiti A, Pasquinelli P, Frediani L, Vituliano A, Brunelleschi G, Lisi C, Rimoldi A, Russo V, Di F, Reggiani A, Raimondo FC, Disalvo D, Borrello VM, Magnante A, Stellitano E, Procopio L, Franculli F, Serafini F, Tondo C, Fiorentini C, Manfredini R, Robbiolo L, Pizzimenti G, Vasquez L, Piangiamore A, Tosi P, Donà G, Bacchiega E, Malavasi V, Modena MG, Divella C, Marengo C, Montanari P, Manicardi V, Abate L, Cuccuini A, Magni S, Vincenti A, Spinelli M, Mortara A, Specchia G, Silvestri N, Silvestri O, Piscopo G, Muscherà R, Gallucci F, Cannavale A, Bresciani A, Perrone Filardi P, Fontanella A, Iannuzzo D, Lucà S, Zuccoli A, Rinaldi P, Ferri G, Barbieri E, Grasselli S, Rossi A, Agosti S, Sanna P, Casu G, Orecchioni G, Da Silva Carvalho PC, Pozzi R, Salvati F, Bendini MG, Giordano G, Pellegrini F, Pighini G, Tremolada F, Zanin L, Ledda A, Floresta AM, Enia F, Nicolosi G, Ingrillì F, D'Angelo A, Musacchio D, Savastano S, Magnani L, Capitelli M, Cioni G, Aloisi B, De Finis A, Vacri A, Costantini V, Guercini F, Zingarini G, Nardoni MC, Teghini L, Panigada G, Vergoni W, Paonessa K, Artom A, Bigliardi M, Riccardi R, Riva L, Marandino A, Barsotti L, Ginocchio G, Marchese D, Tintori G, Annese M, Breschi R, Cipollini F, Manini M, Scopelliti G, Pastore A, Spirito G, Amato A, Del Bianco F, Ongari M, Fiorencis R, Querci F, Martone VD, Molero U, Fiusti R, Giovannini T, D'Arienzo E, Cellamare G, Placci A, Gulli G, Ruggeri A, Pulitanò G, Medicina I, Iori I, Ingianni N, Saporito D, Marconi M, Grossi A, Grosseto D, Ciamei M, Mete F, Russo F, Costantino S, Manfellotto D, Risa MP, Azzolini P, Conversano L, Santini M, Macchiusi A, Francia P, Pietrantonio F, Biscione F, Magliano G, Fedele F, Salituri S, Salituri F, Zamboni S, Rossetti C, Roncon L, Delucchi M, De M, Vitolo A, Anselmi M, Celino T, Moretti V, Cuccurullo M, Castelli G, Martino G, Pierandrei G, Carella AM, Tonizzo M, Nassi R, Tarducci R, Fronticelli Baldelli M, Commisso B, Lazzarini D, Matarazzo MM, Novati P, Caterina S, Petacchi R, Maninchedda P, Melandri F, Bellesi P, Sacchetti C, Grandi M, Cattana A, Tassara R, Menardo G, Aykut V, Chesi G, Reverzani A, Galgano A, Bartone B, Stornello M, Muscio G, Gemmiti MP, Alfonsi F, Fontana D, Astarita C, Gaspardo G, La A, Rillo M, Moscati G, Pascente T, Annunziata SS, Pirozzi MR, Addis L, De P, Beato E, Iannaccone V, Barabani M, Castronuovo M, Battaia L, Biscottini B, Boccali A, Macrì G, Marengo S, Dallerba R, Diana A, Coser A, Pauletto P, Calzolari V, Olivari Z, De Masi De Luca G, Accogli M, Gerloni R, Cattin L, Vitali Serdoz L, Sinagra G, Bulfoni A, De Biasio M, Proclemer A, Miserocchi F, Marazzi R, Salerno JA, Levantesi G, Olivetti P, Capuano A, Bertoncelli MC, Molinaro N, Anastasio L, Teti G, Vescovo GA, Muriago M, Incao F, Lettica GV, Nieswandt V, Osti R, Tafi A.

Abstract

BACKGROUND:

Atrial fibrillation (AF) is associated with a high risk of stroke and mortality.

AIMS:

To describe the difference in AF management of patients (pts) referred to Cardiology (CARD) or Internal Medicine (MED) units in Italy.

METHODS AND 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.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

KEYWORDS:

Anticoagulation; Atrial fibrillation; Guidelines; Rate control; Rhythm control

PMID:
22884698
[PubMed - indexed for MEDLINE]
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