The Retrospective Analysis Of1048Cases Of Hospitalized Patients With Atrial Fibirllation

Objective：1. To investigate the gender, age distribution, and the epidemiology of causes ofhospitalized patients with atrial fibrillation (AF) of the2nd Hospital of Jilin hospitalpatients.2. To investigate the gender, age distribution of patients with stroke ofhospitalized patients suffering from AF, and analyze risk factors related with stroke.3. To investigate the conditions of anti-thromboembolism treatment,antiarrhythmic treatment, and upstream treatment of the hospitalized patients withAF in order to provide a reference for future clinical treatment of hospitalizedpatients with AF.Methods：Retrospective analysis was used to research the hospitalized patients with AFfrom January1,2010to December31,2012in the department of cardiology of2ndhospital of Jilin University, and the patients who were hospitalized and diagnosedwith AF more than once were only counted at the first time, the other times ofhospitalizition were not counted. The basic characteristics of hospitalized patientswith AF, risk factors of AF, thromboembolic complications, and the condition ofdrug treatments were recorded in detail, and performed statistical analysis of eachaspects. Statistical methods: SPSS18.0statistical software was used in the dataanalysis, the enumeration data of normal distribution were expressed as mean±standard deviation, the enumeration data was used the chi-square test, and P <0.05was considered statistically significant.Result：1. From January1,2010to December31,2012, there was a total number of29377cases of hospitalized patients in the department of cardiology of the2ndhospital of Jilin University, and1048cases of hospitalized patients with AF. The proportion of AF patients was3.56%. The age of patients ranged between21to93,the average of age was65.2±12.8years old. The proportion of male was55.2%, andfemale was44.8%. The ratio of male to female was1.23:1. The proportion of agedpeople was51.7%. The number of AF patients increased with the age increasing, andthe largest proportion (31.4%) was from70to79years-old group, the proportion ofthe cases declined in the≥80years-old group. In the group of patients <70yearsold, there were more male than female, however, in the group of patients≥70yearsold, female were slightly more than male.2. In1048cases of patients with AF, the proportion of valvular AF was9.7%,and non-valvular AF was90.3%. The proportion of female in valvular AF wassignificantly higher than the non-valvular AF (P <0.05). The proportion of rheumaticheart disease in valvular AF was76.2%. In the uni-factor analysis of AF, the top fivecauses followed by heart failure (54.9%), coronary heart disease (53.8%), aged(51.7%), hypertension (42.9%), and diabetes (12.0%). The proportion of lone AFwas15.1%.3. The top three causes in patients <40years-old followed by lone AF (33.3%),cardiomyopathy (23.8%), and WPW syndrome (23.8%); the main causes of over60year old group followed by CHD, hypertension, and diabetes. The proportion of loneAF declined with the age increasing, and the proportion of the CHD and the diabetesincreased with the age increasing.4. Divided by gender, in aged patients and CHD with AF, female were morethan male (P <0.05); in the heart failure patients and rheumatic heart disease patientswith AF, female were more than male,(P <0.05). There were more male than femalein lone AF (P <0.05).5. The proportion of patients with ischemic stroke was5.72%in all cases, withan average age of70.4years old. The proportion of ischemic stroke was4.9%inpatients with valvular AF, and5.8%in non-valvular AF (P>0.05). The majority ofstroke patients were male (65%). The aged patients accounted for71.7%in patientswith stroke. In the proportion of aged patients, stroke group was significantly higher than the non-stroke group (P <0.05). The proportion of lone AF in stroke group wassignificantly less than it in non-stroke group (P <0.05).6. In the antithrombotic therapy of patients with AF, the proportion ofantithrombotic therapy was75.2%in all patients. Aspirin accounted for57.3%, andaspirin+clopidogrel accounted for17.9%. The proportion of the patients treatedwith warfarin was only3.4%of all patients. The proportion of using warfarin invalvular AF was higher than it in non-valvular AF (P <0.05). In patients with stroke,there were only two cases using warfarin, which accounted for3.3%of patients withstroke.7. In the treatment of antiarrhythmic947cases of non-valvular AF patients, theproportion of drug cardioversion (rhythm control) was27.8%; the proportion of ratecontrol was57.9%. The proportion of the top three antiarrhythmic treatmentfollowed by beta-blockers(55.3%), digitalis(45.4%) and cardioversion(27.7%).8. In the upstream treatment of AF, the application of statins was62.2%of allthe patients, spironolactone (39.6%), ACEI (34.6%), and ARB (18.4%). In patientswith CHD and hypertension, the drugs of upstream treatments were mainly statinsand beta-blockers; spironolactones, statins, beta-blockers and ACEIs were mainlyuse in patients with heart failure as upstream drugs.Conclusion：1. The number of AF cases increased with the increasing of age. There weremore male than female in the <70years-old group，and female were slightly morethan male in≥70years-old group. It was similar to the results of theepidemiological investigation in domestic and foreign.2. The top five causes of AF in patients were heart failure, CHD, aged,hypertension, diabetes. In patients with aged, CHD, and heart failure, the proportionof female was more than male, and male were more than female in patients with loneAF. It was similar to most of the epidemiological investigation.3. The proportion of patients with ischemic stroke in this study wassignificantly lower than the average level in our country. In the group of stroke, the proportion of elderly patients was higher than it in the non-stroke group, theproportion of patients with lone AF was significantly lower than it in the non-strokegroup.4. The antiplatelet-therapy was the major treatment to the prevention ofthromboembolism in this study. The anticoagulant therapy there is obviouslyinsufficient.5. In the respect of antiarrhythmic-therapy, the proportion of rate control washigher than it in rhythm control. The cardioversion strategy was insufficient.6. In the patients with CHD and hypertension, the drugs of upstream therapywere mainly statins and beta-blockers. In the patients with heart failure, the drugs ofupstream therapy were mainly spironolactone, statins, beta-blockers and ACEIs. Theproportion of upstream treatment was still needed to be improved.