Policy, Payment & Practice -> Clinical Quality Measures and Outcomes D-PO02 - Poster Session II (ID 47) Poster

D-PO02-116 - Clinical Outcomes Of Patients With Incident Atrial Fibrillation Diagnosed By Cardiologists Compared To Non-cardiologists (ID 213)

Disclosure
 T. Chao: Nothing relevant to disclose.

Abstract

Background: The managements of patients with atrial fibrillation (AF) include rate control, rhythm control and stroke prevention, which are mainly the specialties of cardiologists.
Objective: In the present study, we aimed to compare the clinical outcomes of incident AF patients diagnosed by cardiologists and non-cardiologists.
Methods: A total of 75,715 incident AF patients having a CHA2DS2-VASc score >= 1 for males and >=2 for females diagnosed by internists were identified from the Taiwan National Health Insurance Research Database. Patients were furthered divided into 2 groups according to the specialties of internists, that is, cardiologist (n = 52,117) or non-cardiologist (23,598).
Results: Compared to non-cardiologists, incident AF patients diagnosed by cardiologists were more likely to receive rate-control medications (54.3% vs 45.6%, p<0.001), antiarrhythmic drugs (29.9% vs 21.5%, p<0.001) or oral anticoagulants (26.6% vs 19.1%). Digoxin was less prescribed by cardiologists than non-cardiologists (14.9% vs 18.2%, p<0.001). AF patients diagnosed by cardiologists were associated with a lower risk of ischemic stroke (hazard ratio 0.817, p<0.001), mortality (0.805, p<0.001) and combined adverse events (ischemic stroke, intracranial hemorrhage, major bleeding or mortality)(0.845, p<0.001) after the adjustment for the baseline differences and medications (Figure).
Conclusion: Incident AF patients diagnosed by cardiologists were more likely to receive guideline recommended treatments and were associated with a better clinical outcomes compared to those diagnosed by non-cardiologists.
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