Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, Sofia 1431, Bulgaria.
Clinic of Cardiology, UMHAT "St. Ekaterina", Medical University of Sofia, Sofia 1431, Bulgaria.
Medicina (Kaunas). 2018 May 25;54(3):34. doi: 10.3390/medicina54030034.
Atrial fibrillation (AF) is the most common arrhythmia worldwide and a major risk factor for cardiovascular complications. Our study aimed to investigate the prevalence, risk factors, demographics, co-morbidities and treatment of AF among in-hospital Bulgarian patients.
A cross-sectional study including 1027 consecutive patients ( = 516, 50.2% males) with a mean age of 67.6 ± 11.3 years, hospitalized for any reason from 1 May until 31 December 2016 in one of the largest internal clinics in Bulgaria, was carried out.
Atrial fibrillation was diagnosed in 634 (61.7%) patients. The prevalence of modifiable AF risk factors was as follows: heart failure, 98.9%; arterial hypertension (HTN), 93.5%; valvular heart disease, 40.9%; chronic lung disease, 26.7%; type 2 diabetes mellitus, 24.9%; thyroid disease, 16.9%; and ischemic heart disease, 11.2%. Univariate logistic regression analysis identified the following risk factors with strongest impact on AF: left ventricular ejection fraction <40% (odds ratio (OR) = 1.951, 95% confidence interval (CI) 1.208⁻3.151), valvular heart disease (OR = 1.926, 95% CI 1.134⁻3.862), left ventricular ejection fraction 40⁻49% (OR = 1.743, 95% CI 1.248⁻3.017), HTN (OR = 1.653, 95% CI 1.092⁻3.458). History of ischemic stroke was present in 14.4% of the patients with AF. Oral antithrombotic drugs were prescribed to 85.7%: direct oral anticoagulants to 37.9%, vitamin K antagonists to 43.2%, and antiplatelets to 4.6%. Heart rate control medications and antiarrhythmics were prescribed to 75.4% and 40.2%, respectively.
Atrial fibrillation was highly prevalent among our study population. Reduced and mid-range left ventricular ejection fraction, valvular heart disease, and HTN were the risk factors with the strongest association with AF. Although a large number of our AF patients were administered antithrombotic treatment, the prescription rate of oral anticoagulants should be further improved.
心房颤动（AF）是全球最常见的心律失常，也是心血管并发症的主要危险因素。我们的研究旨在调查保加利亚住院患者中 AF 的患病率、危险因素、人口统计学、合并症和治疗情况。
这是一项横断面研究，纳入了 2016 年 5 月 1 日至 12 月 31 日期间在保加利亚最大的内科诊所之一住院的 1027 例连续患者（=516，50.2%男性），平均年龄为 67.6±11.3 岁。
634 例（61.7%）患者诊断为心房颤动。可改变的 AF 危险因素的患病率如下：心力衰竭，98.9%；动脉高血压（HTN），93.5%；瓣膜性心脏病，40.9%；慢性肺部疾病，26.7%；2 型糖尿病，24.9%；甲状腺疾病，16.9%；缺血性心脏病，11.2%。单变量逻辑回归分析确定了对 AF 影响最大的以下危险因素：左心室射血分数<40%（优势比（OR）=1.951，95%置信区间（CI）1.208⁻3.151），瓣膜性心脏病（OR=1.926，95%CI 1.134⁻3.862），左心室射血分数 40⁻49%（OR=1.743，95%CI 1.248⁻3.017），HTN（OR=1.653，95%CI 1.092⁻3.458）。14.4%的 AF 患者有缺血性脑卒中病史。85.7%的患者服用口服抗血栓药物：直接口服抗凝剂 37.9%，维生素 K 拮抗剂 43.2%，抗血小板药物 4.6%。75.4%的患者服用控制心率药物，40.2%的患者服用抗心律失常药物。
我们的研究人群中 AF 的患病率很高。左心室射血分数降低和中范围、瓣膜性心脏病和 HTN 是与 AF 相关性最强的危险因素。尽管我们的许多 AF 患者接受了抗血栓治疗，但口服抗凝剂的处方率仍有待进一步提高。
