A prospective survey of atrial fibrillation management for real-world guideline adherence: Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry

Hyeongsoo Kim, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Ki Woon Kang, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Background and Objectives: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. Results: The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction. Conclusion: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.

Original languageEnglish
Pages (from-to)877-887
Number of pages11
JournalKorean Circulation Journal
Volume47
Issue number6
DOIs
Publication statusPublished - 2017 Nov

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Guideline Adherence
Drug and Narcotic Control
Atrial Fibrillation
Registries
Stroke
Korea
Sotalol
Surveys and Questionnaires
Digoxin
Calcium Channel Blockers
Tertiary Care Centers
Heart Diseases
Therapeutics
Public Health
Guidelines

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Hyeongsoo ; Kim, Tae Hoon ; Cha, Myung Jin ; Lee, Jung Myung ; Park, Junbeom ; Park, Jin Kyu ; Kang, Ki Woon ; Shim, Jaemin ; Uhm, Jae Sun ; Kim, Jun ; Park, Hyung Wook ; Choi, Eue Keun ; Kim, Jin Bae ; Kim, Changsoo ; Lee, Young Soo ; Joung, Boyoung. / A prospective survey of atrial fibrillation management for real-world guideline adherence : Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry. In: Korean Circulation Journal. 2017 ; Vol. 47, No. 6. pp. 877-887.
@article{04104057f3554f93bb88be791053bb1b,
title = "A prospective survey of atrial fibrillation management for real-world guideline adherence: Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry",
abstract = "Background and Objectives: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. Results: The AF type was paroxysmal, persistent, and permanent in 65.3{\%}, 30.0{\%}, and 2.9{\%} of patients, respectively. Underlying structural heart disease was present in 11.9{\%}. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1{\%}, 53.9{\%}, and 54.4{\%} of patients, respectively. OAC was performed in 82.7{\%} of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4{\%} of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40{\%}), β-blocker (65.6{\%}), digoxin (5.2{\%}), or both (19.3{\%}) were adequately used in 90.1{\%} of patients; however, a calcium channel blocker was inadequately used in 9.9{\%}. A rhythm control strategy was chosen in 54.4{\%} of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9{\%} of patients with low ejection fraction. Conclusion: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2{\%}, 9.9{\%}, and 22.4{\%} for stroke prevention, rate control, and rhythm control, respectively.",
author = "Hyeongsoo Kim and Kim, {Tae Hoon} and Cha, {Myung Jin} and Lee, {Jung Myung} and Junbeom Park and Park, {Jin Kyu} and Kang, {Ki Woon} and Jaemin Shim and Uhm, {Jae Sun} and Jun Kim and Park, {Hyung Wook} and Choi, {Eue Keun} and Kim, {Jin Bae} and Changsoo Kim and Lee, {Young Soo} and Boyoung Joung",
year = "2017",
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language = "English",
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pages = "877--887",
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A prospective survey of atrial fibrillation management for real-world guideline adherence : Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry. / Kim, Hyeongsoo; Kim, Tae Hoon; Cha, Myung Jin; Lee, Jung Myung; Park, Junbeom; Park, Jin Kyu; Kang, Ki Woon; Shim, Jaemin; Uhm, Jae Sun; Kim, Jun; Park, Hyung Wook; Choi, Eue Keun; Kim, Jin Bae; Kim, Changsoo; Lee, Young Soo; Joung, Boyoung.

In: Korean Circulation Journal, Vol. 47, No. 6, 11.2017, p. 877-887.

Research output: Contribution to journalReview article

TY - JOUR

T1 - A prospective survey of atrial fibrillation management for real-world guideline adherence

T2 - Comparison study of drugs for symptom control and complication prevention of atrial fibrillation (CODE-AF) Registry

AU - Kim, Hyeongsoo

AU - Kim, Tae Hoon

AU - Cha, Myung Jin

AU - Lee, Jung Myung

AU - Park, Junbeom

AU - Park, Jin Kyu

AU - Kang, Ki Woon

AU - Shim, Jaemin

AU - Uhm, Jae Sun

AU - Kim, Jun

AU - Park, Hyung Wook

AU - Choi, Eue Keun

AU - Kim, Jin Bae

AU - Kim, Changsoo

AU - Lee, Young Soo

AU - Joung, Boyoung

PY - 2017/11

Y1 - 2017/11

N2 - Background and Objectives: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. Results: The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction. Conclusion: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.

AB - Background and Objectives: The aging population is rapidly increasing, and atrial fibrillation (AF) is becoming a significant public health burden in Asia, including Korea. This study evaluated current treatment patterns and guideline adherence of AF treatment. Methods: In a prospective observational registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation [CODE-AF] registry), 6,275 patients with nonvalvular AF were consecutively enrolled between June 2016 and April 2017 from 10 tertiary hospitals in Korea. Results: The AF type was paroxysmal, persistent, and permanent in 65.3%, 30.0%, and 2.9% of patients, respectively. Underlying structural heart disease was present in 11.9%. Mean CHA2DS2-VASc was 2.7±1.7. Oral anticoagulation (OAC), rate control, and rhythm control were used in 70.1%, 53.9%, and 54.4% of patients, respectively. OAC was performed in 82.7% of patients with a high stroke risk. However, antithrombotic therapy was inadequately used in 53.4% of patients with a low stroke risk. For rate control in 192 patients with low ejection fraction (<40%), β-blocker (65.6%), digoxin (5.2%), or both (19.3%) were adequately used in 90.1% of patients; however, a calcium channel blocker was inadequately used in 9.9%. A rhythm control strategy was chosen in 54.4% of patients. The prescribing rate of class Ic antiarrythmics, dronedarone, and sotalol was 16.9% of patients with low ejection fraction. Conclusion: This study shows how successfully guidelines can be applied in the real world. The nonadherence rate was 17.2%, 9.9%, and 22.4% for stroke prevention, rate control, and rhythm control, respectively.

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U2 - 10.4070/kcj.2017.0146

DO - 10.4070/kcj.2017.0146

M3 - Review article

AN - SCOPUS:85039866096

VL - 47

SP - 877

EP - 887

JO - Korean Circulation Journal

JF - Korean Circulation Journal

SN - 1738-5520

IS - 6

ER -