Анализ клинических параметров пациентов с фибрилляцией предсердий и кардиоэмболическим инсультом

Abstract

Th e aim of the research. To assess baseline clinical parameters of patients with atrial fi brillation and to analyse the whole variety of drugs they receive at the time of the development of cardioembolic stroke from the standpoint of evidence-based cardiology. Material and methods. Th e study was conducted at the premises of the neurological department for patients with acute cerebrovascular accidents of the Samara Regional Clinical Hospital named aft er V.D. Seredavin within the period from 2016 to 2019. In total, 139 patients were enrolled, of which 59 were male. Th e average age of the patients was 72.25±6.33. Results. Patients with atrial fi brillation admitted to the primary vascular department due to cardioembolic stroke were characterised by polymorbidity, namely: arterial hypertension was detected in 99.28 %, chronic kidney disease in 53.96 %, coronary heart disease in 30.94 %, diabetes mellitus in 19.42 % of the cases. Subjects with chronic atrial fi brillation prevailed among the studied patients (62.6 % of the cases). Th e risk of thromboembolic complications according to the CHA2DS2-VASc scale before admission to the hospital averaged at 4.37±1.2 points, while 97.84 % of the patients had indications for anticoagulant therapy. However, in real clinical practice, the prevention of thromboembolic complications was only carried out in 13.67 % of the cases and its quality was in compliancy with modern requirements in 3.60 % of the cases only. Conclusion. Th e data obtained attest to cardioembolic stroke developing in polymorbid patients with atrial fi brillation against the background of low quality management of patients with atrial fi brillation at the outpatient-polyclinic stage. Th is may indicate incomplete awareness of doctors about the possible risks of developing a feasibility study in patients with atrial fi brillation, as well as low patient adherence to treatment.