[Prevention of thromboembolism in patients with chronic atrial fibrillation in primary health care].

BACKGROUND AND

OBJECTIVE

Our goal was to evaluate the appropriateness of antithrombotic treatment administration in patients with chronic atrial fibrillation (CAF) attended in a health primary center.

PATIENTS AND METHOD: Transverse and descriptive study; 416 patients diagnosed with CAF were included out of a population of 28,447. Age, sex, embolism risk factors, antithrombotic therapy, contraindications to anticoagulation and stratification risk variables were collected. After a bivariate analysis, a logistic regression model was done to analyze the variable associated with an incorrect antithrombotic therapy.

RESULTS

81% patients were given a correct antithrombotic therapy: 96.8% with a valvular-CAF pattern and 78.2% with a non-valvular CAF pattern. Older the patient, higher the percentage of incorrect antithrombotic administration (t = 3.184; p = 0.002). A greater embolic risk was associated with a better antithrombotic treatment (p < 0.001). The existence of at least one risk factor was also associated with a correct administration (p < 0.001). Hypertension, mitral valvular heart disease and valvular prosthesis were factors associated with a correct antithrombotic therapy. In a multivariate analysis, limited quality of life, mitral valvular heart disease, hypertension and previous systemic embolism behaved all as protective factors of a wrong treatment. An age older than 80 years was associated with a risk of treatment which was 2.89 times higher than that of individuals with the same age or youngers (OR = 2.89; 95% CI, 1.68-4.95).

CONCLUSIONS

Most patients with CAF, both valvular and non-valvular, were properly given antithrombotic therapy. The main factor associated with an incorrect antithrombotic therapy was advanced age.