Fibrilación auricular. Estratificación, tratamiento con anticoagulantes y seguimiento.

Objective: To observe the safety of the new oral anticoagulants compared with vitamin K inhibitors. Patients and method: An observational and prospective study was done with selected patients with non-valvular atrial fibrillation attended at Zacatecas General Hospital from April 2012 to May 2013. To choose antithrombotic or anticoagulant patients were evaluated with CHA2DS2- VASc: Score l aspirin, score 2 or more: dabigatran, rivaroxaban or warfarin, by systematic selection. EHRA classification was employed. Atrial fibrillation was classified in: paroxysmal, persistent, persistent, prolonged or permanent. Endpoints were: stroke, systemic embolism and mortality. A safety criterion was severe bleeding. Results: Thirty-seven patients with non-valvular atrial fibrillation were included, 23 women and 14 men; 97.2% over 50 years; 33 with permanent atrial fibrillation. Two had CHA2DS2-VASc score of 1 and were treated with acetylsalicylic acid, 35 with a score of 2 or more were given vitamin K inhibitors (n=24), dabigatran (n=6) and rivaroxaban (n=5). Conclusions: Complications were: stroke in 10, hemorrhagic diathesis in 9 and mortality in 2 (5.1%). The incidence of stroke (27%) and bleeding diathesis (24%) is high compared with other reports (1.6% and 3.3%, respectively) and are caused by an inadequate anticoagulation. Based on the evaluation criteria and safety criteria, the new oral anticoagulants showed better results than vitamin K inhibitors, in absolute numbers but without statistical significance; these results allow the introduction of a new treatment. [ABSTRACT FROM AUTHOR]