Thromboembolic Outcomes in Patients with Atrial Fibrillation on Two Year Follow Up
Journal of Evidence Based Medicine and Healthcare
A BS T R A C T BACKGROUND Atrial Fibrillation is a common arrhythmia especially in patients with valvular heart disease, hypertension, heart failure, and chronic obstructive lung disease. Aim of this study is to assess the clinical outcomes of thromboembolic events such as stroke, transient ischemic attack, myocardial infarction and peripheral embolism in patients with atrial fibrillation on a 2 year follow up in a tertiary care center in India. METHODS Individuals diagnosed with atrial
... with atrial fibrillation in both outpatient and inpatient department were included. A total of 329 patients was included and followed up for 2 years and analysed for outcomes. RESULTS Permanent AF was diagnosed in 42.6 % (n = 140), persistent in 23.1 % (n = 76) and paroxysmal in 34.7 % (n = 113). Valvular AF (moderate and severe mitral stenosis, prosthetic mechanical valve) was present in 26.7 % (n = 88) and nonvalvular AF in 73.3 % (n = 241). 74.8 % (n = 246) of AF patients were on oral anticoagulants and 4 were on NOAC. During 24 months of follow up, 26 patients (7.9 %) developed thromboembolic events. All were ischemic stroke and 4 were fatal stroke. 4 of these patients defaulted anticoagulants. Time in therapeutic range >60 % (good control) was present in only 3 out of the 26 patients. CONCLUSIONS Though majority of the patients were on oral anticoagulants, they were not under good control (subtherapeutic INR). Frequent monitoring with adequate anticoagulation and adherence to therapy can improve the outcomes in AF patients.