Abstract 12572: One Year Outcomes of Emergency Department Patients With Atrial Fibrillation: A Prospective, Multicenter Registry in China
Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia which independently increases the risk of mortality and morbidity. There is lack of data about patient characteristics, practice patterns and long-time adverse outcomes of AF in Chinese emergency department (ED) patients.
Hypothesis: We assessed the hypothesis that the adverse outcomes of Chinese AF patients presenting to ED were comparable to the western countries.
Methods: The Chinese AF registry is a multicenter, prospective, observational study. AF patients presenting to emergency department were enrolled from November 2008 to October 2011. Data collected included patient demographics, medical history and management of AF in ED. For admitted patients, a follow up was completed to obtain the major adverse events during one year.
Results: The study included 2016 consecutive patients from twenty representative ED centers of China. The mean age was 68.5 years and 54.8% was female. AF was the primary reason for this ED visit in 40.9%. 98.8% (1992) of the baseline population had completed 1 year follow-up. All cause mortality was 291 (14.6%) cases, stroke/non-CNS systemic embolism was 159 (8.0%) cases, and major bleeding was 26 (1.3%) cases. The readmission rate for AF complication, heart failure, and myocardial infarction was 20.5%, 16.6% and 1.1%, respectively. Heart failure was the major cause of mortality, which accounted for 43.0% death. Of 375 (18.6%) patients used warfarin at baseline, only 217(57.9%) patients was stick to anticoagulation therapy during 1 year follow-up. For 1024 patients with a CHADS2 score ≥2, 717 (70%) was prescribed to antiplatelet medicine at baseline, and the rate was 63.7% during one year follow up. Compared with anticoagulant patients, the mortality rate was much higher in those without anticoagulation therapy (15.7% VS 5.5%, p≤0.001), and the stroke risk was also higher although it was not statistically significant (8.4% VS 6.0%, p=0.29).
Conclusions: Patients seen in ED with atrial fibrillation appears to have a high incidence rate of long-time adverse outcomes in China and heart failure was the major cause of death. Anticoagulation therapy with warfarin was effective for AF patients, and the anticoagulant rate was insufficient yet.
- © 2013 by American Heart Association, Inc.