Tratamiento antitrombótico en pacientes con fibrilación auricular: estudio descriptivo en Atención Primaria

Abstract

Background: atrial fibrillation is the mostfrecuent chronic arrithmia in population and it consequences, derived from embolism, may be serious. Actually, to assess the antithrombotic therapy it is advisable in patients with high risk for ictus. Objective: to review the antithrombotic therapy of patients with atrial fibrillation in the context of Primary Health Care attention, and evaluate the adaptation of such therapy compared with actual guidelines. Design, material and method: cross sectional study. Centro de Salud Alcantarilla-Sangonera in Murcia (Spain), an urban centre of ambulatory care, which cares are provided to around 20.000 habitants. All patients with atrial fibrillation registered at data base OMI-AP were included. Results: 124 patients with atrial fibrillation were studied, 66.9% were women and 33.1% men, the mean age was 69. 77 years. At least 50% were older than seventy. The atrial fibrillation was chronic in 95 (76%) patients. Most of them has no structural cardiac disease (63. 7%). It is rare to find patients without risk factors for ictus (16.1%), and most (77.4%) have a high risk. Seventy-nine per cent are undergoing a antithrombotic therapy (50.8% oral anticoagulants and 28.2% antiplatelet therapy). We found the therapy was suitable in 70.2% of patients. Likelihood of a suitable therapy was higher in men, in younger than 75 years, in patients treated with oral anticoagulants, and with those who are not treated in relation to treated with antiplatelet therapy. Conclusions: most of patients with atrial fibrillation, valvular or non-valvular, undergo an antithrombotic therapy, mainly oral anticoagulants, and we found therapy as suitable in most of the cases.