[The use of anticoagulant treatment in patients with nonrheumatic atrial fibrillation].

INTRODUCTION

The efficacy of anticoagulant treatment in the prevention of thromboembolic complications among patients with nonrheumatic atrial fibrillation is established. In our country, data on the use of this therapy in clinical practice are not available.

OBJECTIVE

To examine anticoagulants use among patients with nonrheumatic atrial fibrillation and to analyze the influence of several thromboembolic risk factors in anticoagulant use.

PATIENTS AND METHODS

We have studied, 302 patients retrospectively, with nonrheumatic atrial fibrillation. We determined the presence of heart failure, hypertension, previous thromboembolism, diabetes and left atrium dilation. We added age, sex, pattern of non-permanent arrhythmia and hospitalization and we conducted univariate and multivariate analyses to identify their influence the establishment of the anticoagulant treatment.

RESULTS

28.8% of patients were treated with oral anticoagulants, 83.7% were treated with oral anticoagulant or antiplatelet agents. Only three patients, out of 49, aged 80 years or older were treated with anticoagulants. Multivariate analysis showed that previous thromboembolism (odds ratio 4.03 [1.9-8.1]), permanent atrial fibrillation (odds ratio 2.6 [1.3-5.3]), left atrium dilation (odds ratio 2.3 [1.2-4.1]) and heart failure (odds ratio 1.9 [1.07-3.6]) were factors that predicted higher use of anticoagulant treatment.

CONCLUSIONS

a) Anticoagulant treatment is underused among patients with nonrheumatic atrial fibrillation; b) previous thromboembolism, left atrium dilation and heart failure have conditioned higher probability of undergoing anticoagulant treatment, and c) patients aged 80 years and over and non permanent atrial fibrillation predicted less use of the therapy.