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BioMed Research International
Volume 2015, Article ID 134756, 11 pages
http://dx.doi.org/10.1155/2015/134756
Research Article

Results from the Registry of Atrial Fibrillation (AFABE): Gap between Undiagnosed and Registered Atrial Fibrillation in Adults—Ineffectiveness of Oral Anticoagulation Treatment with VKA

1EAP Tortosa 1-Oest, Institut Català Salut, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Roquetes, 43520 Tortosa, Spain
2EAP Tortosa 1-Est, Institut Català Salut, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Temple, 43500 Tortosa, Spain
3Miguel Hernández University, 03202 Elche, Spain
4EAP-Camarles-Aldea-Ampolla, Institut Català Salut, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Ampolla, 43895 Tortosa, Spain
5EAP Tortosa-2-Oest, Institut Català Salut, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Xerta, 43592 Tortosa, Spain
6Molecular Biology and Research Section, Hospital de Tortosa Verge de la Cinta, IISPV, IDIAP, 43500 Tortosa, Spain
7EAP Deltebre, Institut Català Salut, SAP Terres de l’Ebre, Health Department, Generalitat de Catalunya, CAP Deltebre, 43580 Tortosa, Spain
8Department of Cardiology, Hospital de Tortosa Verge de la Cinta, IISPV, 43500 Tortosa, Spain
9Department of Systems Management, Hospital de Tortosa Verge de la Cinta, Institut Català de la Salut, 43500 Tortosa, Spain
10Pla Director de la Malaltia Vascular Cerebral de Catalunya, Department Salut de la Generalitat de Catalunya, 08005 Barcelona, Spain

Received 26 November 2014; Revised 19 February 2015; Accepted 9 March 2015

Academic Editor: Anamika Bhargava

Copyright © 2015 Anna Panisello-Tafalla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. This study aimed to examine the effectiveness of the use of oral anticoagulation (OAC) medication, recommended by national guidelines for stroke prevention but reportedly underused in AF patients with moderate to high stroke risk. Method. A multicentre and cross-sectional study of undiagnosed AF among out-of-hospital patients over 60 years old was carried out, visiting 3,638 patients at primary health centres or at home for AF diagnosis using the IDC-10 classification. The main outcome measures were , HAS-BLED scores, cardiovascular comorbidity, pharmacological information, TTR, and SAMe-TT2R2 scores. Results. The main findings were undiagnosed AF in 26.44% of cases; 31.04% registered with AF but not using OAC despite 95.6% having a score; a risk of bleeding in important subgroups using OAC without indication (37.50% score); the use of OAC with TTR < 60% (33.1%), of whom 47.6% had a HAS-BLED score ≥3. Thus, 35.4% of the expected AF prevalence achieved an optimal time in the therapeutic range. Conclusions. The expected AF prevalence was 10.9% ( 5267), but the registered prevalence was 7.5% ( 3638). Only 35.04% (CI = 95%, 33.7–36.3) of AF patients treated with vitamin K antagonists (VKAs) achieve the goal of TTR > 60%.