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[Permanent atrial fibrillation in heart disease in Spain. The CARDIOTENS study 1999]
José María García-Acuña1, José Ramón González-Juanatey, Eduardo Alegría Ezquerra
1Hospital Clínico Universitario de Santiago de Compostela, La Coruna, Spain. jgarciaacuna@meditex.es
Introduction And Objective:
Atrial fibrillation is the most common arrhythmia seen in clinical practice. The objective of this study was to know the frequency of atrial fibrillation and the characteristics of patients with atrial fibrillation in the Cardiotens study.
Material And Method:
A cross-section study with systematic selection of the study sample. All 32,051 outpatients seen on the same day by 1,159 physicians specialized in primary-care (79%) and cardiology (21%) were prospectively added to a database including history of cardiac disease (heart failure, coronary disease or atrial fibrillation), blood pressure, and ongoing treatment.
Results:
Atrial fibrillation was present in 25% of patients with previous cardiovascular disease (6,194 patients), the prevalence being 4.8% (1,540/32,051) of the study population. Atrial fibrillation was more frequent in females 29%, (810/2,837) than in males, 22% (730/3,367), p < 0.005). Atrial fibrillation was present in 33% (469/1,420) of patients with heart failure and in 12% (387/3,226) of those with coronary heart disease. Arterial hypertension was diagnosed in 25% of the patients with atrial fibrillation. Only 33% of them were treated with oral anticoagulants (41% of the patients seen by cardiologists and 26% by primary-care physicians, p < 0.005). The antiarrhythmic drug most often used was digoxin (36%).
Conclusions:
Atrial fibrillation had the same frequency and epidemiology in Spain as in other Western countries. Antithrombotic therapy is underused by primary-care physicians and cardiologists.