A prospective survey of atrial fibrillation management for real-world guideline adherence: Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry

Hyeongsoo Kim, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Ki Woon Kang, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

Background and Objectives: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. Results: The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction. Conclusion: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.

Original languageEnglish
Pages (from-to)877-887
Number of pages11
JournalKorean Circulation Journal
Volume47
Issue number6
DOIs
Publication statusPublished - 2017 Nov
Externally publishedYes

Keywords

  • Anticoagulant agent
  • Atrial fibrillation
  • Guidelines adherence
  • Registry

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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    Kim, H., Kim, T. H., Cha, M. J., Lee, J. M., Park, J., Park, J. K., Kang, K. W., Shim, J., Uhm, J. S., Kim, J., Park, H. W., Choi, E. K., Kim, J. B., Kim, C., Lee, Y. S., & Joung, B. (2017). A prospective survey of atrial fibrillation management for real-world guideline adherence: Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry. Korean Circulation Journal, 47(6), 877-887. https://doi.org/10.4070/kcj.2017.0146