Preliminary results of studying the prevalence of atrial fibrillation and the adequacy of prevention of thromboembolic complications

Abstract

Abstract Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia that complicates the course of various cardiovascular diseases, and is also accompanied by the frequent development of thromboembolic complications (TEC), primarily ischemic stroke. In this regard, AF represents a huge socio-economic problem for the health system and society as a whole. Purpose study the real situation in terms of the incidence of various forms of AF and the adequacy of the prevention of TEC among the population of family clinic (FC) №5 in Tashkent. Materials and methods To achieve this goal, out of 12 districts of Tashkent, a (FP) №5 of M. Ulugbek district of Tashkent was selected with a total population of 21,606 people. After exclusion from the study of persons under 18 years of age (n=3546), the total number of adults was 18060 people. Random selection (n=1407) was performed using computer programs with the function of a random number generator in Microsoft Excel. The risk of TEC and bleeding in patients with various forms of AF was assessed using the CHA2DS2-VASc and HAS-BLED score. The study of the situation regarding the compliance of the use of anticoagulants with the current recommendations of the ESC (2020) was carried out by analyzing the structure of the pharmacological prevention of feasibility studies at the time of the survey. Research results: A total of 1407 (725 (51.53%) men) of the population were examined, registered with FC№5 in the M. Ulugbek district of Tashkent. It was found that 406 (28.86%) of the examined patients were diagnosed with coronary heart disease and/or hypertension, 5 (0.36%) of the population were diagnosed with chronic rheumatic heart disease and 369 (26.23%) people with a disease of other organs and systems. In 627 (44.56%) examined patients, non-organic pathologies were found. In general, it was found that 16 (1.13%) out of the total number of examined patients had various clinical forms of AF of both valvular (18.75%) and non-valvular etiology (81.25%). In general, among the identified clinical forms of AF, the permanent form of AF prevailed, amounting to 56.25%, and persistent ones, including long-term persistent and paroxysmal AF were detected in 4 (25%) and 2 (18.75%) patients, respectively. An analysis of the characteristics of the pharmacological prevention of thromboembolic complications showed that at the time of the survey, only 50% of patients were taking the oral anticoagulant therapy recommended in the standards (12.5% warfarin, without proper control of INR and 37.5% of novel oral anticoagulants). Conclusions 1) It was found that the prevalence of various forms of AF was 16 (1.13%) of the total number of patients examined: of these, 56.25% had a permanent form, 25% had a persistent form, and 18.75% had a paroxysmal form. 2) According to the ESC 2020 recommendations, the prevention thromboembolic complications in patients with AF is assessed as unsatisfactory.