FATA Study: Prevalence of Atrial Fibrillation and Antithrombotic Therapy in Primary Health Care in a Northern City of Portugal Estudo FATA: Prevalência de Fibrilhação Auricular e Terapêutica Antitrombótica nos Cuidados de Saúde Primários de um Concelho do Norte de Portugal

نویسندگان

  • Eva GOMES
  • Rui CAMPOS
  • Renata MORAIS
  • Marta FERNANDES
چکیده

RESUMO Introdução: A fibrilhação auricular é a arritmia sustentada mais prevalente. Está provada a eficácia da anticoagulação oral na prevenção do acidente vascular cerebral nestes doentes. Contudo, este parece ser um tratamento subutilizado. Objectivos: determinar a prevalência de fibrilhação auricular conhecida numa população dos Cuidados de Saúde Primários; identificar as principais comorbilidades, a terapêutica antitrombótica em curso e avaliar a sua adequação segundo as recomendações da European Society of Cardiology. Material e Métodos: Estudo observacional transversal analítico. População: todos os utentes com idade igual ou superior a 30 anos, inscritos em oito Unidades de Saúde Familiar de Vila Nova de Gaia, com diagnóstico de fibrilhação auricular. Resultados: A prevalência de fibrilhação auricular foi de 1,29% (n = 940), sendo superior no género masculino (p = 0,01) e aumentando com a idade (p < 0,001). As comorbilidades mais frequentes foram a hipertensão arterial (76,4%), a insuficiência cardíaca (32,0%) e a diabetes mellitus (28,2%). Um total de 52% realizava terapêutica anticoagulante, 29% antiagregantes plaquetários e 4% ambas as terapêuticas. Dos utentes com baixo risco trombótico, 63,6% estava a fazer erradamente algum tipo de terapêutica antitrombótica; dos utentes com elevado risco ou doença valvular 56,8% estava adequadamente sob terapêutica anticoagulante. Conclusão: A prevalência de fibrilhação auricular bem como a frequência das principais comorbilidades estão de acordo com a maioria dos estudos. Apesar de a maioria dos doentes se encontrar sob anticoagulação oral, apenas 56,8% dos utentes com fibrilhação auricular fazia terapêutica antitrombótica adequada segundo as recomendações da European Society of Cardiology, verificando-se uma subutilização acentuada deste tratamento. Palavras-chave: Fibrilhação Auricular; Anticoagulantes; Acidente Vascular Cerebral; Cuidados de Saúde Primários; Portugal. ABSTRACT Introduction: Atrial fibrillation is the most prevalent sustained arrhythmia. The efficacy of oral anticoagulation has been proved in prevention stroke in these patients. However, this seems to be an underutilized treatment. Objectives: to determine the prevalence of known atrial fibrillation in a Primary Health Care population; to identify major comorbidities, current antithrombotic therapy and evaluate their suitability according to the European Society of Cardiology guidelines. Material and Methods: Observational cross-sectional analytical study. Population: all patients aged 30 or above, enrolled in eight Family Health Units of Vila Nova de Gaia and diagnosed with atrial fibrillation. Results: Prevalence of atrial fibrillation was 1.29% (n = 940), being higher in males (p = 0.01) and increasing with age (p < 0.001). The most common comorbidities were hypertension (76.4%), heart failure (32.0%) and diabetes mellitus (28.2%). A total of 52% was performing anticoagulant therapy, 29% antiplatelet agents and 4% both therapies. Of those with low thrombotic risk, 63.6% was wrongly performing some kind of antithrombotic therapy; among patients with high risk or valvular disease 56.8% was properly undergoing anticoagulant therapy. Conclusion: The prevalence of atrial fibrillation as well as the frequency of the main comorbidities associated with it are in line with the majority of studies. Although most patients are undergoing oral anticoagulation, only 56.8% of those with atrial fibrillation was performing adequate antithrombotic therapy as recommended by the European Society of Cardiology guidelines, which denote a marked underutilization of this treatment.

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تاریخ انتشار 2015