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Medicina (Kaunas). 2018 May 25;54(3). pii: E34. doi: 10.3390/medicina54030034.

Risk Factors, Co-Morbidities and Treatment of In-Hospital Patients with Atrial Fibrillation in Bulgaria.

Author information

1
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria. snaydenov@gmail.com.
2
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria. nrunev@abv.bg.
3
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria. doctor_emil_manov@abv.bg.
4
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria. daniela.g.vasileva@gmail.com.
5
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria. yavor.dok@abv.bg.
6
Clinic of Cardiology, UMHAT "St. Ekaterina", Medical University of Sofia, Sofia 1431, Bulgaria. nadma@abv.bg.

Abstract

BACKGROUND AND OBJECTIVES:

Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients.

MATERIALS AND METHODS:

A cross-sectional study including 1027 consecutive patients (n = 516, 50.2% males) with a mean age of 67.6 ± 11.3 years, hospitalized for any reason from 1 May until 31 December 2016 in one of the largest internal clinics in Bulgaria, was carried out.

RESULTS:

Atrial fibrillation was diagnosed in 634 (61.7%) patients. The prevalence of modifiable AF risk factors was as follows: heart failure, 98.9%; arterial hypertension (HTN), 93.5%; valvular heart disease, 40.9%; chronic lung disease, 26.7%; type 2 diabetes mellitus, 24.9%; thyroid disease, 16.9%; and ischemic heart disease, 11.2%. Univariate logistic regression analysis identified the following risk factors with strongest impact on AF: left ventricular ejection fraction <40% (odds ratio (OR) = 1.951, 95% confidence interval (CI) 1.208⁻3.151), valvular heart disease (OR = 1.926, 95% CI 1.134⁻3.862), left ventricular ejection fraction 40⁻49% (OR = 1.743, 95% CI 1.248⁻3.017), HTN (OR = 1.653, 95% CI 1.092⁻3.458). History of ischemic stroke was present in 14.4% of the patients with AF. Oral antithrombotic drugs were prescribed to 85.7%: direct oral anticoagulants to 37.9%, vitamin K antagonists to 43.2%, and antiplatelets to 4.6%. Heart rate control medications and antiarrhythmics were prescribed to 75.4% and 40.2%, respectively.

CONCLUSIONS:

Atrial fibrillation was highly prevalent among our study population. Reduced and mid-range left ventricular ejection fraction, valvular heart disease, and HTN were the risk factors with the strongest association with AF. Although a large number of our AF patients were administered antithrombotic treatment, the prescription rate of oral anticoagulants should be further improved.

KEYWORDS:

atrial; embolic; fibrillation; in-hospital; prevention; risk

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