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A Prospective Survey of Atrial Fibrillation Management for Real-world Guideline Adherence: COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) Registry

Authors
 Hyeongsoo Kim  ;  Tae-Hoon Kim  ;  Myung-Jin Cha  ;  Jung Myung Lee  ;  Junbeom Park  ;  Jin-Kyu Park  ;  Ki-Woon Kang  ;  Jaemin Shim  ;  Jae-Sun Uhm  ;  Jun Kim  ;  Hyung Wook Park  ;  Eue-Keun Choi  ;  Jin-Bae Kim  ;  Changsoo Kim  ;  Young Soo Lee  ;  Boyoung Joung 
Citation
 Korean Circulation Journal, Vol.47(6) : 877-887, 2017 
Journal Title
 Korean Circulation Journal 
ISSN
 1738-5520 
Issue Date
2017
Keywords
Anticoagulant agent ; Atrial fibrillation ; Guidelines adherence ; Registry
Abstract
BACKGROUND AND OBJECTIVES: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. METHODS: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. RESULTS: The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA₂DS₂-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction. CONCLUSION: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.
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DOI
10.4070/kcj.2017.0146
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실)
Yonsei Authors
김창수(Kim, Chang Soo) ORCID logo https://orcid.org/0000-0002-5940-5649
엄재선(Uhm, Jae Sun) ORCID logo https://orcid.org/0000-0002-1611-8172
정보영(Joung, Bo Young) ORCID logo https://orcid.org/0000-0001-9036-7225
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165111
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