Anticoagulant therapy in atrial fibrillation with acute coronary syndrome in real clinical practice according to the total register of acute coronary syndrome in the Krasnodar Territory

Abstract

Objective: to analyze patients with first-time developing atrial fibrillation (AF), against acute coronary syndrome (ACS), risk factors for arrhythmia, assessment of patients’ adherence to oral anticoagulant therapy 6–24 months after the ACS episode, according to the total ACS registry for the Krasnodar Territory. Materials and methods: A retrospective analysis of the case histories of 13,244 patients admitted to the infarction departments of all settlements of the Krasnodar Territory without exception and included in the ACS regi-stry for the Krasnodar Territory from November 20, 2015 to January 20, 2018. Results: The study group of ACS with AF included 201 patients, among them 144 men (71.642%), women 57 (28.358%). The average age was 68,084 ± 9,606 years, a maximum of 85 years, a minimum of 25 years. The frequency of the following outcomes was assessed: hospital mortality, frequency of hemorrhagic, throm-boembolic complications. The effectiveness of prognostic scales of development of hemorrhage CRUSADE and HAS BLED was evaluated and the expediency of prescribing extended OAT to patients with the first developed AF attack against the background of ACS after discharge from the hospital. Conclusions: Based on the obtained results, based on the data of the total ACS register for the Krasnodar Territory, we can conclude: 1. Patients with a newly developed episode of AF on the background of ACS have demograph-ic, anamnestic data comparable with other types of AF; 2. Patients with a newly developed AF episode on the background of ACS have a more severe course of the disease, which does not affect hospital mortality, hospital complications and lethality after 6–24 months after discharge from the hospital for ACS; 3. Patients with a newly developed episode of AF on the background of ACS after discharge from the hospital do not have arrhythmia recurrences, they do not have thromboembolic complications. The decision on the duration of oral anticoagulant therapy should be carried out after carrying out a multi-day monitoring of the ECG.