DESFECHOS E FATORES PROGNÓSTICOS DE PACIENTES COM FIBRILAÇÃO ATRIAL
Palabras clave:
Fibrilação atrial, Tromboembolia, PrognósticoResumen
O objetivo deste estudo foi descrever desfechos e fatores prognósticos de pacientes com fibrilação atrial, atendidos em um hospital geral. Estudo de coorte retrospectivo, observacional e não-controlado. Foram considerados como desfechos: óbito, internação por causa cardiovascular, evento tromboembólico e hemorragia. Dentre os 71 pacientes acompanhados, durante aproximadamente três anos, 50,7% foram a óbito, 44,4% por causa cardiovascular; 18,3% apresentaram internação por causa cardiovascular, 11,3% eventos tromboembólicos e 2,8% eventos hemorrágicos. Os fatores prognósticos associados aos eventos desfavoráveis foram: QRS alargado no eletrocardiograma, aumento do tamanho do átrio esquerdo e uso de medicamento para controle da frequência cardíaca. Em nossa casuística de pacientes com FA em hospital geral, observou-se significativa frequência de óbitos.
Referencias
January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64:1–76.
Heinisch RH, Leal FM, Heinisch LMM. Atualização em fibrilação atrial. Arq Catarin Med 2013; 42:93-9.
Camm JA, Kirchhof P, Lip GYH, et al. Guidelines for the management of atrial fibrillation the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Euro Heart J 2010; 31:2369-429.
Hoffmann J. Fatores prognósticos em pacientes com fibrilação atrial [trabalho de conclusão de curso]. Florianópolis: Universidade Federal de Santa Catarina, Curso de Medicina, Departamento de Clínica Médica; 2011.
Hansson A, Härdig BM, Olsson SB. Arrhythmia-provoking factors and symptoms at the onset of paroxysmal atrial fibrillation: A study based on interviews with 100 patients seeking hospital assistence. BMC Cardiovascular Disorders 2004; 4:1-9.
Kirchhof P, Auricchio A, Bax J, et al. Outcome parameters for trials in atrial fibrillation: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork and European Heart Rhythm Association. Europace. 2007; 9:1006-23.
Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093–100.
Lip GY, Frison L, Halperin JL, Lane D. Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke 2010; 41:2731-8.
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: 2370–5.
Wilke T, Groth A, Mueller S, et al. Incidence and prevalence of atrial fibrillation: na analysis based on 8.3 million patients. Europace 2013; 15: 486-93.
Kannel WB, Benjamin EJ. Final draft status of the epidemiology of atrial fibrillation. Med Clin North Am 2008; 92: 17-ix.
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014; 64:1–76.
Heeringa J, Kuip DAM, Hodman Albert, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Euro Heart J 2006; 27:949–53.
Santos EB, Salles ALF, Tavares LR, et al. Características clínicas e demográficas e perfil terapêutico de pacientes hospitalizados com fibrilação atrial: Estudo EPIFA. Rev SOCERJ 2009; 22: 9-14.
Vermond RA, Crijns HJGM, Tijssen JGP, et al. Symptom severity is associated with cardiovascular outcome in patients with permanent atrial fibrillation in the RACE II study. Europace 2014; 16:1417-25.
Nazli C, Eren NK, Tülüce SY, et al. Impaired quality of life in patients with intermittent atrial fibrillation. Anatol J Cardiol 2015; 15: 6144.
Nabauer M, Gerth A, Limbourg T, et al. The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management. Europace 2009; 11:423-34.
Chyou JY, Hunter TD, Mollenkopf AS, et al. individual and combined risk factors for incident atrial fibrillation and incident stroke: an analysis of 3 million at-risk us patients. J Am Heart Assoc 2015; 4: e001723 (doi: 10.1161/JAHA.114.001723)
Lubitz AS, Benjamin EJ, Ellinor PT. Atrial fibrillation in congestive heart failure. Heart Fail Clin 2010; 6: 187–200.
Zimerman LI, Fenelon G, Martinelli Filho M et al. Sociedade Brasileira de Cardiologia. Diretrizes Brasileiras de Fibrilação Atrial. Arq Bras Cardiol 2009; 92: 1-392.
Pastore CA, Pinho C, Germiniani H, et al. Diretrizes da Sociedade Brasileira de Cardiologia sobre Análise e Emissão de Laudos Eletrocardiográficos. Arq Bras Cardiol 2009; 93:1-19.
Osranek M, Bursi F, Bailev KR, et al. Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up. Eur Heart J. 2005; 26:2556-61.
Mosquera AB, Broullón F, Alvarez-Garcia N, et al. Left atrial size and risk for all-cause mortality and ischemic stroke. CMAJ 2011; 183: 657–64.
Beinart R, Heist EK, Newell JB, et al. Left atrial appendage dimensions predict the risk of stroke/TIA in patients with atrial fibrillation. J Cardiov Electrophysiol 2011; 22:10-5.
Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146: 857–67.
Wallentin L, Yusuf S, Ezekowitz MD et al. Ef?cacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial ?brillation: an analysis of the RE-LY trial. Lancet 2010; 376: 975–83.
Patel MR, Mahaffey KW, Garg J et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365: 883–91.
Caldeira D, David C, Sampaio C. Rate versus rhythm control in atrial fibrillation and clinical outcomes: Updated systematic review and meta-analysis of randomized controlled trials. Arch Cardiovasc Dis 2012;105: 226-38.
Van Gelder IC, Groenveld HF, Crijns HJGM, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med 2010; 362:1363-73.
Kimura KM, Yamaguchi T. Atrial fibrillation as a predictive factor for severe stroke and early death in 15831 patients with acute ischaemic stroke. J Neurol Neurosurg Psychiatry 2005; 76: 679-83.
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2016 Arquivos Catarinenses de Medicina
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
