Clinical characteristics and stratification of the cerebrovascular accident risk among patients with atrial fibrillation in Colombia, 2011-2016

ABSTRACT

Background: Atrial fibrillation (AF) is the most common type of cardiac arrhythmia worldwide. This study aimed to determine the sociodemographic and clinical features of AF in a Colombian population.

Methods: An observational, retrospective study was conducted using a sample of patients diagnosed with AF. Electronic medical records were reviewed to determine specific sociodemographic, clinical, risk stratification, outcome, and pharmacological variables.

Results: A total of 357 patients with a mean age of 69.4 ± 13.3 years were included; 52.4% (n = 187) were women. Most patients (84.0%; n = 300) had an elevated risk of thromboembolism and an indication for anticoagulation, but 72 (24.0%) of these patients did not receive such treatment. Among the patients, 23.2% had HAS-BLED scores ≥3. During the study period, 76 patients (21.3%) had 121 adverse events, of which 75.2% (n = 91) were any bleeding events (major, minor, etc.) and 24.8% (n = 30) were thrombosis events (i.e., stroke). At the end of the follow-up period, the number of prescriptions for direct anticoagulants had increased, and warfarin decreased.

Conclusions: AF primarily affects Colombian adults >65 years old. A high burden of comorbidities and a risk of thromboembolism were found in most patients; however, lack of treatment was evident in a large percentage of cases.

KEYWORDS:

• Atrial fibrillation
• arrhythmias
• cardiac
• anti-arrhythmia agents
• anticoagulants
• pharmacoepidemiology

Article Highlights

• Atrial fibrillation (AF) is a common disease associated with important negative outcomes.

• From 357 Colombian patients with AF, more than 80% had an elevated risk of thromboembolism.

• Despite having an indication for anticoagulation, 24% of the patients did not receive such therapy at any time.

• The use of direct oral anticoagulants has increased over time.

• Research regarding AF in Colombia is limited, and new studies are necessary to improve the knowledge of this disease in the region.

Acknowledgments

To Soffy Lopez and Carlos Tovar by data base collection.

Authors contributions statement

DAMM participated in the drafting, data collection, data analysis, description of results, discussion, critical revision of the article, and evaluation of the final version of the manuscript. AGM participated in the drafting, data collection, data analysis, description of results, discussion, critical revision of the article, and evaluation of the final version of the manuscript. MEMD participated in the drafting, data collection, data analysis, description of results, discussion, critical revision of the article, and evaluation of the final version of the manuscript. AFCV participated in the drafting, data collection, data analysis, description of results, discussion. JEMA participated in the drafting, data collection, data analysis, description of results, discussion, critical revision of the article, and evaluation of the final version of the manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work received funding from Universidad Tecnológica de Pereira and Audifarma SA. Grant Number: 5-17-6.