open access

Vol 11, No 6 (2016)
Young Cardiology
Published online: 2017-01-16
Get Citation

Thromboembolic complications in the group of hospitalized patients with atrial fibrillation — evaluation of the frequency and analysis of risk factors

Anna Stec, Anna Kmita, Iwona Gorczyca-Michta, Paweł Salwa, Beata Wożakowska-Kapłon
DOI: 10.5603/FC.2016.0108
·
Folia Cardiologica 2016;11(6):511-518.

open access

Vol 11, No 6 (2016)
Young Cardiology
Published online: 2017-01-16

Abstract

Introduction. Thromboembolic complications are the most serious complications of atrial fibrillation (AF). Usually, they involve the central nervous system; however, embolism may also be located in the peripheral arteries. The aim of the study was to determine the frequency of thromboembolic complications and to identify the risk factors for their occurrence in hospitalized patients with AF.
Materials and methods. The study group consisted of 962 patients with non-valvular AF who were hospitalized in a reference cardiology center in 2007–2009. The risk of thromboembolic events in patients with AF were determined using CHADS2 and CHA2DS2VASc scales.
Results. In the examined group of 962 patients with AF, the majority of patients (n = 674, 70%), were at the age of more than 70 years and 467 patients (48.5%) had permanent AF. No differences in frequency of arrhythmia between men and women were found. The majority of examined patients were at high risk of thromboembolic events as indicated by CHADS2 score — 869 patients (90.3%) and CHA2DS2VASc score — 882 patients (91.7%). The mean CHADS2 score was 2.4 points, while mean CHA2DS2VASc score — 4.2 points. The most common condition, and at the same time a thromboembolic risk factor included in the CHADS2 scale, was hypertension found in 763 patients (79.3%). The majority of patients (n = 578, 60.1%) had also impaired renal function. Thromboembolic complications occurred in 162 patients (16.8%): 135 patients (83.3%) had ischemic stroke, 14 patients (6.6%) — transient ischemic attack (TIA), 1 patient (0.6%) — stroke and TIA, and 12 patients (7.4%) — peripheral thromboembolic complications. Conclusions.
 The majority of hospitalized AF patients evaluated in our study were elderly patients with high risk of thromboembolic complications and chronic arrhythmia. The most common risk factors of thromboembolic complications in the examined group were older age and hypertension. CHADS2 and CHA2DS2VASc scores were higher in patients with AF and impaired renal functions than in patients with AF and normal renal function. Peripheral embolism was identified in every 13th patient with thromboembolic complications and AF.

Abstract

Introduction. Thromboembolic complications are the most serious complications of atrial fibrillation (AF). Usually, they involve the central nervous system; however, embolism may also be located in the peripheral arteries. The aim of the study was to determine the frequency of thromboembolic complications and to identify the risk factors for their occurrence in hospitalized patients with AF.
Materials and methods. The study group consisted of 962 patients with non-valvular AF who were hospitalized in a reference cardiology center in 2007–2009. The risk of thromboembolic events in patients with AF were determined using CHADS2 and CHA2DS2VASc scales.
Results. In the examined group of 962 patients with AF, the majority of patients (n = 674, 70%), were at the age of more than 70 years and 467 patients (48.5%) had permanent AF. No differences in frequency of arrhythmia between men and women were found. The majority of examined patients were at high risk of thromboembolic events as indicated by CHADS2 score — 869 patients (90.3%) and CHA2DS2VASc score — 882 patients (91.7%). The mean CHADS2 score was 2.4 points, while mean CHA2DS2VASc score — 4.2 points. The most common condition, and at the same time a thromboembolic risk factor included in the CHADS2 scale, was hypertension found in 763 patients (79.3%). The majority of patients (n = 578, 60.1%) had also impaired renal function. Thromboembolic complications occurred in 162 patients (16.8%): 135 patients (83.3%) had ischemic stroke, 14 patients (6.6%) — transient ischemic attack (TIA), 1 patient (0.6%) — stroke and TIA, and 12 patients (7.4%) — peripheral thromboembolic complications. Conclusions.
 The majority of hospitalized AF patients evaluated in our study were elderly patients with high risk of thromboembolic complications and chronic arrhythmia. The most common risk factors of thromboembolic complications in the examined group were older age and hypertension. CHADS2 and CHA2DS2VASc scores were higher in patients with AF and impaired renal functions than in patients with AF and normal renal function. Peripheral embolism was identified in every 13th patient with thromboembolic complications and AF.

Get Citation

Keywords

atrial fibrillation, thromboembolic complications, risk factors

About this article
Title

Thromboembolic complications in the group of hospitalized patients with atrial fibrillation — evaluation of the frequency and analysis of risk factors

Journal

Folia Cardiologica

Issue

Vol 11, No 6 (2016)

Pages

511-518

Published online

2017-01-16

DOI

10.5603/FC.2016.0108

Bibliographic record

Folia Cardiologica 2016;11(6):511-518.

Keywords

atrial fibrillation
thromboembolic complications
risk factors

Authors

Anna Stec
Anna Kmita
Iwona Gorczyca-Michta
Paweł Salwa
Beata Wożakowska-Kapłon

References (19)
  1. Benjamin EJ, Wolf PA, D'Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998; 98(10): 946–952.
  2. Czlonkowska A, Ryglewicz D, Weissbein T, et al. A prospective community-based study of stroke in Warsaw, Poland. Stroke. 1994; 25(3): 547–551.
  3. Niewada M, Skowrońska M, Ryglewicz D, et al. Polish National Stroke Prevention and Treatment Collaborative Group. Acute ischemic stroke care and outcome in centers participating in the Polish National Stroke Prevention and Treatment Registry. Stroke. 2006; 37(7): 1837–1843.
  4. Benjamin EJ, Wolf PA, D'Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998; 98(10): 946–952.
  5. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001; 285(18): 2370–2375.
  6. Członkowie grupy roboczej ESC.. Wytyczne ESC dotyczące postępowania w migotaniu przedsionków na 2012 rok. Kardiol Pol. 2012; 70(suppl IV): 197–234.
  7. Pruszczyk P, Hryniewiecki T, Drożdż J. Kardiologia z elementami angiologii część II. Medical Tribune Polska, Warszawa 2009: 118–142.
  8. Kawecka-Jaszcz K, Pośnik-Urbańska A, Jankowski P. Rozpowszechnienie nadciśnienia tętniczego w zależności od płci w świetle badań epidemiologicznych w Polsce. Nadciś Tętn. 2007; 11: 377–383.
  9. Rajzer M, Kawecka-Jaszcz K. Podatność tętnic w nadciśnieniu tętniczym. Od patofizjologii do znaczenia klinicznego. Nadciś Tętn. 2002; 6: 63.
  10. Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol. 1994; 74(3): 236–241.
  11. Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation. 1991; 84(2): 527–539.
  12. Heeringa J, van der Kuip DAM, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006; 27(8): 949–953.
  13. Kannel WB, Abbott RD, Savage DD, et al. Coronary heart disease and atrial fibrillation: the Framingham Study. Am Heart J. 1983; 106(2): 389–396.
  14. Gorczyca-Michta I, Wożakowska-Kapłon B. New oral anticoagulants for the prevention of thromboembolic complications in atrial fibrillation: a single centre experience. Kardiol Pol. 2015; 73(2): 85–93.
  15. Banecka-Majkutewicz Z, Nyka WM, Krześniak-Bohdan M, et al. Analiza czynników ryzyka udaru niedokrwiennego mózgu (badanie wstępne). Udar Mózgu. 2002; 4: 18–20.
  16. Kirchhof P, Schmalowsky J, Pittrow D, et al. ATRIUM Study Group, ATRIUM investigators. Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry. Clin Res Cardiol. 2011; 100(10): 897–905.
  17. Lee M, Saver JL, Chang KH, et al. Low glomerular filtration rate and risk of stroke: meta-analysis. BMJ. 2010; 341: c4249.
  18. Piccini J, Stevens S, Chang Y, et al. Renal Dysfunction as a Predictor of Stroke and Systemic Embolism in Patients With Nonvalvular Atrial FibrillationClinical Perspective. Circulation. 2012; 127(2): 224–232.
  19. Frost L, Engholm G, Johnsen S, et al. Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation. Arch Intern Med. 2001; 161(2): 272–276.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

 

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl