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Atrial fibrillation (AF) is the most common cardiac arrhythmia. To assess the need for anticoagulation is essential for its management. Our objective was to investigate whether the indication of anticoagulation was adequate in patients diagnosed with non-valvular AF, given the CHA2-DS2-VASc scale, measuring the International Normalizad Ratio range (INR) in patients treated with anti-vitamin K drugs.This is an observational and cross sectional study. 232 patients with atrial fibrillation were included. We analyzed demographic, the CHA2-DS2-VASc and HAS-BLED variables, the treatment and INR values for 6 consequentive months. The confrontation of variables was performed using chi-square and Mantel-Haenzel test.The prevalence of AF was 1.05%. The 88.4% had CHA2-DS2-VASc ≥ 2. The 71.1% were taking anticoagulants, of which 58.2% were under antivitamin k. The 46.7% of patients taking antivitamin K, presented inadequate range of INR. There was a greater prescription of antivitamin k in patients with persistent or permanent AF compared to the paroxysmal form (62.8 vs. 37.2% p.001). The use of drugs that increase bleeding was associated with a worse control of INR after adjustment for the main variables of clinical relevance (odds ratio 2.17 [1.02-4.59], p=.043).The level of anticoagulation with antivitamin K was inadequate in our sample, despite a proper follow up and adherence to treatment. Patients with paroxysmal AF received less antivitamin K than those with persistent/permanent AF.

ObjetivosDeterminar el nivel de conocimiento, las pautas de actuación y el control sobre las dislipidemias de los médicos de atención primaria y especializada españoles.Diseño e intervenciónSe ha diseñado un cuestionario autodefinido formado por 12 ítems donde se completan datos acerca de la población tratada y la valoración subjetiva sobre los objetivos, el tratamiento y el control de los parámetros lipídicos.Emplazamiento y participantesHa participado un total de 1.998 médicos de todo el territorio nacional. El 68,8% de los medicos entrevistados trabaja en atención primaria de salud y el 30,2%, en centros de especialidades o en hospitales.ResultadosGlobalmente, el 91% de los médicos declara seguir los consensos internacionales sobre el control de las dislipidemias. El parámetro objetivo terapéutico para tratar las dislipidemias más utilizado es el colesterol unido a lipoproteínas de baja densidad (cLDL) (83%), seguido del colesterol total (62%), el colesterol unido a lipoproteínas de alta densidad (cHDL) (56%) y los triglicéridos (51%). Ante un paciente bien controlado, el 21,8% de los facultativos reduce la dosis del hipolipidemiante. En líneas generales, no se aprecian grandes diferencias entre los criterios que siguen los médicos de atención primaria y los de atención especializada.ConclusionesLos criterios de actuación ante las dislipidemias son mejorables. No hay diferencias importantes en las opiniones y actuación entre médicos de atención primaria y especialistas en los criterios clínicos y terapéuticos ante las dislipidemias.ObjectivesTo find the level of knowledge, the guidelines for action and the monitoring of lipaemia by Spanish primary care and specialist doctors.Design and interventionA self-defined questionnaire of 12 items was designed. Data on the population treated and the subjective evaluation of objectives, and on the management and monitoring of lipid parameters were filled in.Setting and participantsA total of 1998 doctors from the whole of Spain took part; 68.8% of the doctors interviewed worked in primary health care and 30.2% in specialist centres or hospitals.ResultsA 91% of the doctors said they followed international consensus on monitoring lipaemia. The most commonly used objective therapeutic parameter for treating lipaemia was LDL-cholesterol (83%), followed by total cholesterol (62%), HDL-cholesterol (56%) and triglycerides (51%). If the patient's lipaemia was well controlled, then 21.8% of doctors reduced the doses of lipid-lowerers. In general terms, no great differences were appreciated between the criteria followed by PC and by specialist doctors.ConclusionsThe criteria for action on lipaemia could be improved. There are no important differences of view or action in clinical and therapeutic criteria for Lipaemia cases between PC and specialist doctors.