2017

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2017/№4

Retrospective analysis of the clinical status of patients with atrial fibrillation preceding acute coronary syndrome: Local register data

Tarlovskaya E. I.1, Dorofeeva J. A.2, Malcikova S. V.2
1 – Nizhny Novgorod State Medical Academy, pl. Minina i Pozharskogo 10/1, Nizhny Novgorod 603005, Russia
2 – Kirov State Medical University, K. Marx 112, Kirov 61002, Russia

Keywords: retrospective analysis, register, atrial fibrillation, acute coronary syndrome, cardiovascular risk factors, polymorbidity

DOI: 10.18087/rhj.2017.4.2368

Aim. To study the structure of risk factors and cardiovascular and other comorbidities preceding acute coronary syndrome (ACS) in patients with atrial fibrillation (AF) in real-life outpatient practice using a registry in the territory of Kirov region, the Russian Federation, where cardiovascular mortality is high. Materials and methods. The registry included 163 patients with AF who were moved from vascular centers to the hospital of the Kirov State Medical Academy for post-ACS medical rehabilitation between June, 2013 and June, 2015. Results. Mean age of patients was 64.9±9.7 (55.8% men and 44.2% women). Among cardiovascular diseases (CVD) that had existed before the hospitalization for ACS, the most common were AH (92.02%), CHF (81.6%), and IHD (78.53%). Diagnosis of AF was present in 64.42% of medical records before the hospitalization for ACS. Mean number of CVD diagnoses (other than AF) was significantly larger for patients with previous AF than for patients with newly diagnosed AF (4.6±1.81 vs 3.26±2.2, p<0.001). There were no differences in mean numbers of diagnosed concomitant (non-cardiac) diseases (2.47±1.91 vs 1.86±1.91, p=0.055). Mean number of all diagnoses (CVD + non-cardiac diseases) was greater for patients with earlier diagnosed AF (7.0±2.82 vs 5.0±3.07, p<0.001). Among cardiovascular risk factors, the most common were gender factors (74.8%) and dyslipidemia (76.69%), including increased total cholesterol (CHS) (50.9%), increased LDL CHS (53.4%), and decreased HDL CHS (43.6%). 32.5% of patients had obesity, 31.9% - complicated family history, 22.7% - disordered carbohydrate metabolism, and 19.6% of patients were smokers. Conclusion. For patients with AF, the retrospective analysis of pre-ACS cardiovascular risk factors and a combination of cardiovascular and concomitant diseases in real-life outpatient practice generally did not significantly differ from registry data for patients with similar conditions in other regions of Russia, European countries and China. Most patients included into the registry had pronounced comorbidities. Medical records of patients for the pre-ACS period did not contain adequate information about CVD factors, particularly about LDL CHS and waist circumference.
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Tarlovskaya E. I., Dorofeeva J. A., Malcikova S. V. Retrospective analysis of the clinical status of patients with atrial fibrillation preceding acute coronary syndrome: Local register data. Russian Heart Journal. 2017;16(4):235–245

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