Risk factors in cerebral thromboembolic complications in patients with non-valvular permanent atrial fibrillation
Keywords:
atrial fibrillation, warfarin, INR, therapeutic adherenceAbstract
Introduction: atrial fibrillation is the most frequent cardiac arrhythmia that is treated in clinical practice and produces 33% of hospitalizations associated with arrhythmias.
Objective: to identify risk factors for cerebral thromboembolic complications in patients with permanent non-valvular atrial fibrillation and oral anticoagulant treatment between 2015 and 2018.
Method: a case-control study was conducted in the General Teaching Hospital "Dr Agostinho Neto" in the period October between 2015 and April 2018. The universe consisted of 213 patients, 71 cases with permanent atrial fibrillation who suffered cerebral thromboembolic complications under treatment with warfarin and 142 controls with permanent atrial fibrillation, with the same, but without the aforementioned complications. Two controls were selected for each case (2: 1) to increase the statistical power of the study. We analyzed sociodemographic, clinical, echocardiographic variables, lability of the INR (international normalized index) and therapeutic adhesions. The analysis of the data was presented in double entry data tables. Chi square, Confidence Intervals and Odds ratio were estimated.
Results: the age group of 75 or more years, the male sex, arterial hypertension, the presence of plaques of atheroma in the aorta and carotids, diabetes mellitus, suboptimal INR, poor therapeutic adherence were significant.
Conclusions: the age group of 75 years or older, male sex, smoking, high blood pressure, diabetes mellitus, atheromatous plaques in the aorta and carotids, suboptimal INR and poor therapeutic adherence constitute significant risk factors for the appearance of cerebral thromboembolic complications.Downloads
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