Features of pharmacotherapy and clinical course of atrial fibrillation in patients with type 2 diabetes in real clinical practice. Saratov Journal of Medical Scientific
Year: 2014, volume 10 Issue: №1 Pages: 178-185
Heading: Parmacology Article type: Original article
Authors: Graifer l.V., Reshetko O.V., Furman N.V., Dolotovskaya P.V.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Heading: Parmacology Article type: Original article
Authors: Graifer l.V., Reshetko O.V., Furman N.V., Dolotovskaya P.V.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:
The aim of the study was to investigate the clinical status of patients with atrial fibrillation (AF) and diabetes mellitus (DM) type 2 and to identify differences in the treatment of AF, conducted in the cardiology departments of multidisci-plinary teaching hospitals of the Saratov city. Materials and methods. A comparative retrospective analysis of 1041 pharmacoepidemiological solid history of patients with AF who were hospitalized in emergency, and in the planning department of cardiology of 2 multidisciplinary teaching hospitals of the Saratov city consecutively in a calendar year on the AF, recorded on an electrocardiogram. Results. Among all patients with AF, patients with DM accounted for 20.2%. Among them were women, they were younger, they developed fibrillation at a younger age, they differed more severe structural heart disease, among which was significantly greater with myocardial infarction, nearly all had symptoms of heart failure. Patients with DM performed less frequently cardioversion, and to monitor heart rate often preferred a combination of beta-blockers and digoxin. 100% of patients with DM had a higher risk of thromboembolic complications (91.9% without diabetes) in both groups, oral anticoagulants (OAC) prescribed often enough. Conclusion. DM was diagnosed in every fifth patient with AF, especially among women and patients with persistent AF and is associated with the presence of more severe organic heart disease compared with patients without DM. All patients on the background DM was a high risk of thromboembolic complications, i.e. OAC must be assigned in 100% of cases, but in the surveyed hospitals OAC were appointed only in 23% of cases.
Bibliography:
1. Diagnosis and treatment of atrial fibrillation. Rossiyskiy kardiologicheskiy zhurnal 2013; 4 (102), Annex 3. URL: http://scardio.ru/content/Guidelines/FP_rkj_13.pd;
2. Krijthe ВР, Kunst A, Benjamin EJ, et al Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J 2013; 34: 2746-2751;
3. Rivero-Ayerza M, Scholte op Reimer W, Lenzen M, et al. New-onset atrial fibrillation is an independent predictor of in-hospital mortality in hospitalized heart failure patients: results of the EuroHeart Failure Survey. Eur Heart J 2008; 29: 1618-1624;
4. Stramba-Badiale M. Atrial fibrillation subtypes, risk of stroke, and antithrombotic therapy. Eur Heart J 2008; 29: 840-842;
5. Nabauer M, Gerth A, Limbourg T, et al. The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management. Europace 2009; 11: 423-434;
6. Boriani G, Glotzer TV, Santini M, et al. Device-detected atrial fibrillation and risk for stroke: an analysis of >10000 patients from the SOS AF project (Stroke prevention Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J 2014; 35: 508-516;
7. Lip GYH, Laroche C, Dan G-A, et al. A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURObservational Research Programme Atrial Fibrillation (EORP-AF). Pilot General Registry Europace 2014; 16: 308-319;
8. Kirchhof P, Lip GYH, Van Gelder 1С, et al. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options: a report from the 3rd Atrial Fibrillation Competence NETwork / European Heart Rhythm Association consensus conference Europace 2012; 14: 8-27;
9. Ryden L, Standl E, Bartnik M, et al. Guidelines on diabetes, pre diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J 2007; 9 (Suppl C): 3-74;
10. Syrkin AL, Sulimov VA, Fomina IG, et al. Clinical recommendations for the diagnosis and treatment of atrial fibrillation. Kardiovaskulyarnaya terapiya i profilaktika 2005; 4 (Annex 1);
11. Du X, Ninomiya Т, Galan В de, et al. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the advance study. Eur Heart J 2009; 30: 1128-1135;
12. Wolf PA, Abbott RD, and Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham study Stroke. 1991;22:983-988;
13. Kanorsky SG, Kanorskaya YS. Atrial fibrillation in patients with diabetes mellitus type 2: developmental and preventive treatment. Kardiologiya 2010; 7: 31-37;
| Attachment | Size |
|---|---|
| 2014_01-01_178-185.pdf | 275.12 KB |
Русский
English