OBJECTIVES

Atrial fibrillation (AF) is the most common form of cardiac arrhythmia, however, the treatment patterns of AF in China are not well understood. This research aimed to identify the AF population in China and document their baseline demographic characteristics, treatment patterns, and percentages of treated and untreated AF patients.

METHODS

A retrospective analysis was conducted using the SuValue database, which is an EMR database covering over 100 million patients from 192 hospitals across 22 provinces in China. AF patients were identified based on ICD-9-CM (427.3x) and ICD-10-CM (I48.9x) diagnosis codes. The patients included in this study were adults who received services consistently from the same hospital for more than 6 months. Descriptive data analysis was conducted on patient demographics, CHA₂DS score, CHA₂DS₂-VASc score, treatment patterns, prescriptions, outpatient and inpatient encounter information.

RESULTS

A total of 100,862 patients with atrial fibrillation (mean age 69±14 years) were identified. Among them, 12.4% (N=12,513; age 70±14) regularly received services from the same hospitals for more than 6 months. Of these AF patients, 49.7% are female and 41.8% are married. Common comorbidities include hypertension (48.8%), coronary artery disease (41.1%), heart failure (25.3%), and COPD (13.3%). Majority of the patients were treated with anticoagulants/antiplatelets (62.2%), beta-blockers (53.6%), calcium channel blockers (1.1%), and heart rhythm medicines (13.9%). 11,378 patients (90.9%) had a CHA₂DS₂-VASc score greater than zero, among which 35.2% (N=4,006) were improperly untreated according to treatment guidelines for stroke prevention. Among those taking anticoagulants, 40.1% (N=4,559) used more than one anticoagulant, either concurrently or consecutively. The top 4 commonly used anticoagulants are aspirin (64.3%), heparin (65%), clopidogrel (33.0%), and warfarin (20.7%).

CONCLUSIONS

The results indicate that a considerable number of patients received suboptimal therapies. The percentage of patients that potentially require anticoagulants treatments yet remain untreated is relatively high, suggesting better clinical management is needed.