2017


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2017/№1

Practice of managing patients with atrial fibrillation: A real situation as exemplified by the Moscow R egistry of 2009–2015

Melekhov A. V.1, Gendlin G. E.1, Nikitin I. G.1, Alekseeva E. M.1, Dadashova E. F.1, Zakharova I. I.2, Varentsov S. I.2
1 – Federal State Budgetary Educational Institution of Higher Education, "N.I. Pirogov Russian National Research Medical University " of the Ministry of Health of the Russian Federation, Ostrovityanova 1, Moscow 117997
2 – State Budgetary Institution of Health Care, "Municipal Clinical Hospital #24 of the Moscow Department of Health Care", Pistsovaya 10, Moscow 127015

Keywords: atrial fibrillation, stroke, risk factors, preventive measures, anticoagulants, International Normalized Ratio (INR)

DOI: 10.18087/rhj.2017.1.2296

Background. Analysis of data from observational programs and registries showed a significant gap between the knowledge on the role of atrial fibrillation (AF) in development of cardioembolic stroke, possibilities of its prevention using anticoagulants (ACs), and implementation of current recommendations in practice. Aim. To evaluate the reality in practice of managing patients with AF. Materials and methods. A registry was formed, which included 1860 patients older than 18 with non-valvular AF who received in- or outpatient treatment at different Moscow healthcare institutions in 2009-2015. Results. 99.1% of patients included into the registry had indications for coronary bypass; approximately half of the patients had a low risk of hemorrhagic complications; and in a significant number of patients, the risk could be additionally reduced by treatment of AH. Adequate use of coronary bypass was performed only in 16.3% of patients before hospitalization; in 31.8% – during the stay in hospital; and in 55.6% – one year after discharge from the hospital. Among patients receiving warfarin, only 24.6% reached the INR goal before hospitalization; 30.8% – during their stay in the hospital; and 78.3% – in one year after the discharge. In 2014–2015, the rate of warfarin and new oral anticoagulant (NOAC) treatments increased but remained low. Conclusion. Anticoagulants are not prescribed frequently enough to patients with AF. This situation could be corrected by more extensive use of warfarin and NOACs and by improved INR monitoring during the warfarin treatment.
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Melekhov A.V., Gendlin G.E., Nikitin I.G., Alekseeva E.M, Dadashova E.F., Zakharova I.I. et al. Practice of managing patients with atrial fibrillation: A real situation as exemplified by the Moscow Registry of 2009-2015. Russian Heart Journal. 2017;16 (1):73–80.

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