A Prospective Survey of Atrial Fibrillation Management for Real-world Guideline Adherence: Comparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) Registryopen access
- Authors
- Kim, Hyeongsoo; Kim, Tae-Hoon; Cha, Myung-Jin; Lee, Jung Myung; Park, Junbeom; Park, Jin-Kyu; Kang, Ki-Woon; Shim, Jaemin; Uhm, Jae-Sun; Kim, Jun; Park, Hyung Wook; Choi, Eue-Keun; Kim, Jin-Bae; Kim, Changsoo; Lee, Young Soo; Joung, Boyoung
- Issue Date
- Nov-2017
- Publisher
- KOREAN SOC CARDIOLOGY
- Keywords
- Atrial fibrillation; Anticoagulant agent; Guidelines adherence; Registry
- Citation
- KOREAN CIRCULATION JOURNAL, v.47, no.6, pp.877 - 887
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN CIRCULATION JOURNAL
- Volume
- 47
- Number
- 6
- Start Page
- 877
- End Page
- 887
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/4003
- DOI
- 10.4070/kcj.2017.0146
- ISSN
- 1738-5520
- Abstract
- Background and Objectives
The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment.
Methods
In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea.
Results
The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction.
Conclusion
This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.
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