Aplicación de la estrategia ABC en una población de pacientes con fibrilación auricular que reciben antagonistas de la vitamina K

Resum

Introduction: Atrial fibrillation is the most common sustained cardiac arrhythmia in adults and anticoagulant therapy is considered one of the fundamental pillars of the treatment of this pathology. Due to the longevity of the population, patients with atrial fibrillation may have numerous comorbidities, receiving multiple drugs, which is called polypharmacy. The atrial fibrillation better care (ABC pathway; A: avoid stroke, B: better symptom control, C: cardiovascular risk factors and other comorbidities management) was developed with the aim of carrying out a comprehensive and structured management of atrial fibrillation in order to improve the patient´s adherence to treatment and reduce adverse clinical events. In Spain, vitamin K antagonists is still high used for stroke prevencion, however, there are few studies relating the ABC pathway in this group of patients. Objectives: To evaluate adherence to the ABC pathway and its influence on adverse clinical events and on the quality of anticoagulation control in a cohort of patients with atrial fibrillation who were receiving vitamin K antagonists. In addition to stablish the prevalence, risk factors and the clinical events associated with polypharmacy. Methods: A prospective study was carried out, which included a cohort of 1050 outpatients diagnosed with non-valvular atrial fibrillation, who started therapy with vitamin K antagonists from July 2016 to June 2018. Conclusions: In our cohort, more than a half of the patients showed adherence to the ABC pathway. Such adherence reduces adverse clinical effects and improves the quality of anticoagulation control. Polypharmacy had a high prevalence, being associated with multiple risk factors and causing an increase in adverse clinical events.