Study On Clinical Features Of Patients With Atrial Fibrillation In Community-dwelling Older Adults

Objective: To analyze atrial fibrillation types,related diseases,thromboembolic risk score and present situation of antithrombotic therapy of of elderly patients with atrial fibrillation in community to provide guidance for the management of these patients.Methods: A total of 30643 elderly people over 65 years old in 11 communities in Jinshan District,Shanghai were taken into health examination with cluster sampling from April to October in 2013.Then a cross-sectional survey was conducted on 1801(5.9%)patients screened out atrial fibrillation.The questionnaires on the status of atrial fibrillation,which are completed by the researchers,mainly included social demography,general health,history of present Illness,history of past illness,underlying diseases as well as the clinical features of atrial fibrillation.A total of 1416 valid questionnaires were collected.The CHADS2 score,the CHA2DS2-VASc score and the HAS-BLED risk score were analyzed according to the CHD criteria for the atrial fibrillation stroke risk assessment system of electrophysiology and pacing Branch of the Chinese Medical Association in 2015.Then patients' conditions to receive the antithrombotic treatment are analyzed.Results:1.The proportion of male and female with atrial fibrillation in the community is 0.98: 1,with an average age of 76.1± 6.4.The overall prevalence rate is 5.9%(1801/30643).The prevalence of atrial fibrillation in male patients is higher than that in women(6.8%: 5.1%,P = 0.000).2.16.4% of these patients with atrial fibrillation had a history of smoking,13.7% had a history of alcohol use and 4.4% has family history of atrial fibrillation.3.Patients of paroxysmal atrial fibrillation,persistent atrial fibrillation and permanent atrial fibrillation account for 60.4%,18.6%,8.3% and 12.8%,respectively.4.The most common complications among patients with atrial fibrillation were in turn 59.7% for hypertension,35.4% for coronary heart disease,9.5% for diabetes,2.5% for sick sinus syndrome,2.2% for left ventricular hypertrophy,1.8% for heart failure,0.8% for hyperthyroidism,0.4% for cardiomyopathy and 0.1% for rheumatic heart disease.5.There are 592 Patients with atrial fibrillation whose CHADS2 score is greater than 2,only 4.7% of which received anticoagulant therapy and 27.7% received antiplatelet therapy,604(42.7%)patients whose CHADS2 score equals 1,5.3% of which received anticoagulant therapy and 18.5% received antiplatelet therapy,and 220(15.5%)patients with CHADS2 score equals 0,6.4% of which received anticoagulant therapy and 20.0% received antiplatelet therapy.Only 5.2% 1293 patients with atrial fibrillation whose CHA2DS2-VASc scores is greater than 2 received anticoagulant therapy and 22.9% of them received antiplatelet therapy.5.7% of 123(8.7%)patients whose CHA2DS2-VASc score equals 1 received anticoagulant therapy and 19.5% of them received antiplatelet therapy.Conclusion: The proportion of patients with first diagnosed atrial fibrillation was relatively high among the elderly patients with atrial fibrillation;patients whose thromboembolic risk score is greater than 2 account for a significant share but the proportion of patients who received antithrombotic therapy is low.