[Adherence of patients with atrial fibrillation after acute coronary syndrome to antithrombotic therapy at stage III of cardiac rehabilitation: data from the local register of the Kirov region].

Abstract

Aim      To evaluate the quality of antithrombotic therapy (ATT) in patients with atrial fibrillation (AF) after acute coronary syndrome (ACS) at stage 3 of rehabilitation.Material and methods  The registry included 163 patients with AF (mean age, 65.0 [59.0; 72.0] years; 55.8 % men) undergoing rehabilitation after ACS (ACS <1 month ago) in the hospital of the Kirov State Medical University.Results Recommendations for 73.6 % of patients on ATT provided upon discharge from the hospital after stage 2 of rehabilitation were consistent with clinical guidelines (CG). During the entire stage 3, 25.8% of patients had acute cardiovascular complications (CVC) or urgent interventions (8.0% died). Furthermore, the ATT was actually consistent with CG only in 9.2 % of patients; in 21.5 %, errors in changing the ATT timing were detected; and in 84.1 %, various mistakes in the control of international normalized ratio were observed. On the whole, 3.6% of patients incorrectly adjusted their ATT independently, and for 15.3%, the attending physician made incorrect APT adjustments.Conclusion      In AF patients after ACS who were undergoing stage 3 of rehabilitation, the quality of the ATT was low despite the recommendations at discharge from the hospital, which depended not only on the patient but also on the attending physician.