02864nas a2200241 4500008004100000245007000041210006900111260001500180300001000195490000600205520214000211653001702351653003502368653002402403653002802427100001802455700001802473700001802491700001802509700001502527700002002542856006002562 2018 eng d00aAtrial Fibrillation, Clinical Profile and Adherence to Guidelines0 aAtrial Fibrillation Clinical Profile and Adherence to Guidelines cMarch 2018 a05-080 v93 a

Background: Even in developed countries suboptimal anticoagulation and low adherence to guidelines is frequently observed in Atrial fibrillation (AF) patients. There is no data from our regional population and very scarce Indian data about the utilization patterns and adherence to guidelines for stroke prevention in AF. Aims and Objectives: To characterize clinical profile and assess adherence to guidelines in stroke prevention in AF in north Indian population. Material and Methods: It was a single centre observational study. All patients presenting to outpatient department or admitted in cardiology wards from May 2014 to April 2016 with AF were included. Detailed history, examination and relevant investigations were carried out .CHADS2 score was used for risk stratifying and prescribing oral anticoagulants in nonvalvular AF. The effectiveness of oral anticoagulant was assessed by INR. Result: Total of 446 patients were included. Mean age of our patients was 60.83±16.86 years. 48% were males and 52% were females. Rheumatic heart disease was most common (37.2%) ethology followed by hypertensive cardiovascular disease (18.2%). Mean CHADS2 score was 2.63±1.5 in non valvular AF. Out of 446 patients, 409(92%) patients were found to have indication for prescription of OAC as per guidelines, out of which only 290 (71%) patients actually received OAC. OAC prescription was significantly higher in valvular vs. non valvular AF ( p=0.0001).The rates of OAC prescription in our patients in age group, ≤65, 66-75, >75 years were 84.4%, 65% and 60.2% respectively Out of 290 patients who were eligible for OAC ,only 102(25%) patients were optimally anti-coagulated. Conclusion: Discordance between guidelines and practice was found regarding prescription of OACs and maintenance of optimal anticoagulation for stroke prevention in our population. Optimal anticoagulation needs to be emphasized on both patients as well as physicians to prevent strokes and achieve better outcomes.

10aCHADS2 score10aInternational normalized ratio10aOral Anticoagulants10aValvular heart disease.1 aKumar, Mukesh1 aRashid, Aamir1 aIqbal, Shamim1 aHafeez, Imran1 alone, Ajaz1 aAslam, Khurshid uhttp://jcdronline.org/article/2018/9/1/105530jcdr201812 ?> ?>