FIBRILHAÇÃO AURICULAR: INCIDÊNCIA, PREVALÊNCIA E PERCENTAGEM DE HIPOCOAGULADOS NUMA CONSULTA HOSPITALAR DE UMA UNIDADE DE SAÚDE DO INTERIOR
DOI:
https://doi.org/10.58043/rphrc.35Keywords:
Atrial Fibrillation, Incidence, Prevalence, AnticoagulationAbstract
Introduction: Atrial fibrillation is the most frequent arrythmia in clinical practice, leading to an increase in the individual’s morbidity and overall mortality. This study aims to investigate the prevalence, incidence, percentage of individuals anticoagulated and the relationship between this arrythmia and other factors.
Methods: Retrospective, descriptive and observational study in a sample of patients who attended Cardiology and Hypertension appointments in Centro Hospitalar Universitário Cova da Beira for six months in 2019, through the consultation of clinical processes at SClínico, from which data was collected such as gender, age, anticoagulant medication, presence or absence of atrial fibrillation, hypertension, obstructive sleep apnea, smoking habits, body mass index and events of stroke, transient ischemic attack and/or acute myocardial infarction. Statistical analysis was performed by using SPSS®.
Results: In a sample of 391 people, there was a prevalence of 16,9% of atrial fibrillation and an incidence of 5,23 per 100 patients in 6 months. Of the patients with atrial fibrillation, 68,2% are anticoagulated, being Rivaroxaban the one that is the most used of all anticoagulants: 28,9%. Half of the patients with atrial fibrillation are males, 39,4% are between 70 and 79 years old, 87,9% have hypertension, 25,8% have obstructive sleep apnea, 6,1% are smokers, 4,5% had a stroke, 4,5% had a transient ischemic attack and 16,7% had an acute myocardial infarction. There was no relationship found between atrial fibrillation and the other variables, except for age and anticoagulation.
Conclusion: The prevalence of atrial fibrillation obtained in this study is high, which entails that an early diagnosis is needed due to the morbidity and mortality that this arrythmia causes and that it is crucial to prevent the risk factors that lead to atrial fibrillation, reinforcing the role of Primary Health Care in them.
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References
Bonhorst D, Mendes M, Adragão P, De Sousa J, Primo J, Leiria E, et al. Prevalence of atrial fibrillation in the Portuguese population aged 40 and over: the FAMA study. Rev Port Cardiol. 2010;29:331- 50.
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–962.
Cea-Calvo L, Redón J, Lozano J V., Fernández-Pérez C, Martí- Canales JC, Llisterri JL, et al. Prevalencia de fibrilación auricular en la población Española de 60 o más años de edad. Estudio PREV- ICTUS. Rev Esp Cardiol [Internet]. 2007;60(6):616–24. Available from:
http://dx.doi.org/10.1157/13107118
Heeringa J, Van Der Kuip DAM, Hofman A, Kors JA, Van Herpen G, Stricker BHC, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: The Rotterdam study. Eur Heart J. 2006;27(8):949–53.
Benjamin EJ, Levy D, Vaziri SM, D’agostino RB, Belanger AJ, Wolf PA. Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort: The Framingham Heart Study. JAMA J Am Med Assoc. 1994;271(11):840–4.
Kathryn M. Ryder, Emelia J. Benjamin. Epidemiology and Significance of Atrial Fibrillation.Am J Cardiol 1999;84:131R-138R 7. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, et al, editors. Harrison’s Principles of Internal Medicine. 20th Edition. New York: The McGraw-Hill Companies, Inc.; 2018. p. 1746-1750.
Zimetbaum P. In the clinic. Atrial fibrillation. Annals of internal medicine. 2010;153(11):ITC61-ITC616
Gouveia M, Costa J, Alarcão J, Augusto M, Caldeira D, Pinheiro L, et al. Carga e custo da fibrilhação auricular em Portugal. Rev Port Cardiol. 2015;34(1):1–11.
Gomes E, Campos R, Morais R, Fernandes M. Estudo FATA: Prevalência de fibrilhação auricular e terapêutica antitrombótica nos cuidados de saúde primários de um concelho do norte de Portugal. Acta Med Port. 2015;28(1):35–43.
Monteiro P. The SAFIRA study: A reflection on the prevalence and treatment patterns of atrial fibrillation and cardiovascular risk factors in 7500 elderly subjects. Rev Port Cardiol [Internet]. 2018;37(4):307–13. Available from: https://doi.org/10.1016/j. repc.2017.08.006
Primo J, Gonçalves H, Macedo A, Russo P, Monteiro T, Guimarães J, et al. Prevalence of paroxysmal atrial fibrillation in a population assessed by continuous 24-hour monitoring. Rev Port Cardiol. 2017;36(7–8):535–46.
Ascensão P. Fibrilhação auricular tromboembolismo. Rev Port Clin geral. 2006;22:13–24.
Lane DA, Skjøth F, Lip GYH, Larsen TB, Kotecha D. Temporal trends in incidence, prevalence, and mortality of atrial fibrillation in primary care. J Am Heart Assoc. 2017 Apr 28;6(5):e005155. doi: 10.1161/JAHA.116.005155.
Marques da Silva P. [Old and new oral anticoagulants. Pharmacological perspective]. Rev Port Cardiol [Internet]. 2012;31 Suppl 1:6–16. Available from: http://dx.doi.org/10.1016/S0870- 2551(12)70034-3
Gomez-Doblas JJ, Muñiz J, Martin JJ, Rodríguez-Roca G, Lobos JM, Awamleh P, et al. Prevalencia de fibrilación auricular en España. Resultados del estudio OFRECE. Rev Esp Cardiol. 2014;67:259-69.
Ministério da Saúde (2018). Retrato da Saúde. Lisboa: Ministério da Saúde; 2018. p. 14,18.
Vizzardi E, Sciatti E, Bonadei I, D’Aloia A, Curnis A, Metra M. Obstructive sleep apnoeahypopnoea and arrhythmias: New updates. J Cardiovasc Med. 2014;15:000-000.
Monahan K, Storfer-Isser A, Mehra R, Shahar E, Mittleman M, Rottman J, et al. Triggering of Nocturnal Arrhythmias by Sleep-Disordered Breathing Events. J Am Coll Cardiol [Internet]. 2009;54(19):1797–804. Available from: http://dx.doi.org/10.1016/j. jacc.2009.06.038
Goudis CA, Ketikoglou DG. Obstructive sleep and atrial fibrillation: Pathophysiological mechanisms and therapeutic implications. Int J Cardiol [Internet]. 2016;230:293–300. Available from: http://dx.doi.org/10.1016/j.ijcard.2016.12.120.
Qureshi WT, Nasir U Bin, Alqalyoobi S, O’Neal WT, Mawri S, Sabbagh S, et al. Meta-Analysis of Continuous Positive Airway Pressure as a Therapy of Atrial Fibrillation in Obstructive Sleep Apnea. Am J Cardiol [Internet]. 2015;116(11):1767–73. Available from: http://dx.doi.org/10.1016/j.amjcard.2015.08.046