Prevalence, Risk factors and Pharmacological treatment of Atrial Fibrillation in Older Hospitalized Patients in Vietnam

• Main Authors: Tu N Nguyen, Huyen T Vu, Thanh X Nguyen, Thang Pham, Sarah N Hilmer, Robert G Cumming
• Format: Article
• Language: English
• Published: Barcaray International 2016-01-01
• Series: International Cardiovascular Forum Journal
• Subjects: Atrial fibrillation; prevalence; Vietnam; risk factors; frailty
• Online Access: http://icfjournal.org/index.php/icfj/article/view/339/Nguyen%20339%20pp79-84

Background: The evidence about prevalence of atrial fibrillation (AF) in Vietnam is very limited and there have been no published studies about the pharmacological treatment of AF in older Vietnamese patients. This study aims to investigate the prevalence of AF, its associated factors and pharmacological treatment in older hospitalized patients in Vietnam.The secondary aim is to investigate the impact of frailty, an emerging geriatric syndrome which is still a new concept in Vietnam, on the pharmacological treatment of AF. Methods: We used data from a study of the prevalence of frailty in older hospitalized patients at the National Geriatric Hospital in Hanoi, Vietnam. Consecutive patients aged ≥60 years were recruited from 4/2015 to 10/2015. Results: A total of 461 patients was recruited, 56.8% were female, and mean age was 76.2±8.9. The prevalence of AF was 3.9% (18 patients). Amongst patients with AF, the most common medical conditions were hypertension (72.2%), followed by stroke (55.6%), heart failure (50.0%), type2 diabetes (44.4%). Living alone (OR=10.2, 95%CI 1.5–70.1), having a habit of using vitamins at home (OR=3.8, 95%CI 1.1–13.4), having heart failure (OR=31.3, 95%CI 9.6–101.8), and having type 2 diabetes (OR=3.5, 95%CI 1.2–10.7) were associated with the presence of AF on admission. All patients with AF had a high risk of stroke (CHA2DS2-VASc score≥2) and 72.2% of them had a high risk of bleeding with anticoagulant medications (HAS-BLED score≥3). Only 22.2% were anticoagulated on admission and 22.2% upon discharge, with no difference between frail and non-frail patients. Conclusions: The prevalence of AF among older hospitalized patients in Vietnam is similar to that reported in other countries. Anticoagulation for stroke prevention was underused, without any significant difference between frail and non-frail patients.