Anticoagulation in atrial fibrillation and antiplatelet in diabetes mellitus type 2. How do we do it?

Abstract

Background. In spite of evidence about the interest of anticoagulation in Atrial Fibrillation (AF) and antiplatelet to diabetics (DM) type 2, the national and international references describe a low level of assumption of those criteria in practice. Published studies on these aspects are unavailable in Navarre. Methods. Cross-sectional study. Population: primary care patients (1,600 people > 15 years). Inclusion criteria: patients diagnosed of AF / with diagnosis of DM type 2, over 40. Variables: age and sex, criteria of AF with high embolic risk (>6% annual) and cardiovascular risk factors in DM2. Data collection: in computerised registers of Organisation and Management Information. Analysis: (population universe studied), results in absolute numbers and percentages. Results. Twenty-five people with diagnosis of chronic FA (14 women and 11 men, average age 78.36 years); 22 (81.8%) show high embolic risk. There were counter-indications in 4 cases. Type 2 diabetics totalled 69 people (29 women and 40 men, average age 68.57 years). There are 16 (23.1%) in primary prevention (PP), 26 (37.3%) in secondary prevention (SP), and 27 (39.1%) do not follow antiplatelet therapy. There is counter-indication in 8 cases and 14 patients (20.2%) would be susceptible to intervention. Conclusions – The results of oral anticoagulant therapy (OAT) in high risk AF exceed the reviewed references. – The PP with DM2 are similar figures to other studies; a area of improvement was detected. – We must ask for the opinion of the patient and individualise these therapies. – The family doctor has a significant responsibility in cardiovascular prevention of the patients affected by these problems.