Real-world management of elderly Chinese patients with atrial fibrillation revealed significant care gaps, with 54.8% not receiving appropriate oral anticoagulants and a 1-year mortality of 6.8%.
Observational (n=6,420)
Yes
This large-scale registry highlights significant gaps in guideline-directed care for elderly Chinese patients with atrial fibrillation, particularly the severe underuse of oral anticoagulation in high-risk patients.
AIMS: To evaluate the quality measures and clinical performance indicators among elderly Chinese patients with atrial fibrillation (AF). The management of patients with AF requires a holistic, multidisciplinary approach. Quality indicators have been proposed to assess the quality of care in 'real-world' clinical practice when managing patients with AF. METHODS AND RESULTS: The Optimal Thromboprophylaxis in Elderly Chinese Patients with Atrial Fibrillation (ChiOTEAF) registry is a prospective, observational, large-scale multicentre registry conducted between October 2014 and December 2018 in China. Data were collected at the enrolment and during the follow-up visits by the local investigators. In the ChiOTEAF registry, 14 primary and 8 secondary indicators from six domains of care were assessed. Six thousand four hundred twenty patients who completed the 1-year follow-up were included in the analysis. Median age was 76 years, and the majority of patients was male (60.8%). Overall, 3246 patients (54.8%) were not treated with oral anticoagulants (OACs) appropriate to their risk of stroke; specifically, among those at highest risk of stroke, OACs were prescribed in only 43.3% patients (1258/2905). Among patients with permanent AF, 32 (3.6%) were prescribed antiarrhythmic drugs, and among those with paroxysmal AF, catheter ablation was performed in 20.7%. Patients were overburdened with multi-morbidities, including hypertension, diabetes mellitus, obesity, and sleep apnoea. During 1-year follow-up, 435 deaths (6.8%) and 89 thromboembolic events (1.4%) occurred. Patient-reported outcomes showed that 55% of patients had indicators of reduced quality of life. CONCLUSION: Assessment of quality indicators revealed the gaps in AF care among Chinese patients, highlighting the need for a more integrated or holistic approach to AF management.
Guo et al. (Tue,) conducted a observational in Atrial fibrillation (n=6,420). Real-world AF management was evaluated on 14 primary and 8 secondary quality indicators from six domains of care. Real-world management of elderly Chinese patients with atrial fibrillation revealed significant care gaps, with 54.8% not receiving appropriate oral anticoagulants and a 1-year mortality of 6.8%.