Powikłania zakrzepowo-zatorowe u hospitalizowanych chorych z migotaniem przedsionków — ocena częstości występowania i analiza czynników ryzyka

Abstract

Introduction. Thromboembolic complications are the most serious complications of atrial fibrillation (AF). Usually, they involve the central nervous system; however, embolism may also be located in the peripheral arteries. The aim of the study was to determine the frequency of thromboembolic complications and to identify the risk factors for their occurrence in hospitalized patients with AF. Materials and methods. The study group consisted of 962 patients with non-valvular AF who were hospitalized in a reference cardiology center in 2007–2009. The risk of thromboembolic events in patients with AF were determined using CHADS 2 and CHA 2 DS 2 VASc scales. Results. In the examined group of 962 patients with AF, the majority of patients (n = 674, 70%), were at the age of more than 70 years and 467 patients (48.5%) had permanent AF. No differences in frequency of arrhythmia between men and women were found. The majority of examined patients were at high risk of thromboembolic events as indicated by CHADS 2 score — 869 patients (90.3%) and CHA 2 DS 2 VASc score — 882 patients (91.7%). The mean CHADS 2 score was 2.4 points, while mean CHA 2 DS 2 VASc score — 4.2 points. The most common condition, and at the same time a thromboembolic risk factor included in the CHADS 2 scale, was hypertension found in 763 patients (79.3%). The majority of patients (n = 578, 60.1%) had also impaired renal function. Thromboembolic complications occurred in 162 patients (16.8%): 135 patients (83.3%) had ischemic stroke, 14 patients (6.6%) — transient ischemic attack (TIA), 1 patient (0.6%) — stroke and TIA, and 12 patients (7.4%) — peripheral thromboembolic complications. Conclusions. The majority of hospitalized AF patients evaluated in our study were elderly patients with high risk of thromboembolic complications and chronic arrhythmia. The most common risk factors of thromboembolic complications in the examined group were older age and hypertension. CHADS 2 and CHA 2 DS 2 VASc scores were higher in patients with AF and impaired renal functions than in patients with AF and normal renal function. Peripheral embolism was identified in every 13 th patient with thromboembolic complications and AF.