Anticoagulation – ABC CARDIOL

ABC

Letter to the Editor

How to Improve Clinical Outcomes in Women with Atrial Fibrillation

To the editor

Anticoagulation is a standard therapeutic approach for patients with atrial fibrillation (AF), requiring careful consideration of the balance between antithrombotic efficacy and the risk of hemorrhagic complications. The authors examined the rate of anticoagulant prescriptions among patients admitted to the emergency department with symptomatic AF, revealing a higher prevalence of non-prescription in women compared to men. This observation raises several important concerns.

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ABC

Editorial

Women and Atrial Fibrillation: Is the Disparity in Anticoagulation Just a Question of Gender? In Search of the Brazilian Reality

Jorge Elias Neto et al. Fernando Luiz Torres Gomes

The discussion of atrial fibrillation (AF) must begin with the premise that certainly, alongside other conditions such as obesity — and in a particularly harmful partnership with it — this rhythm disturbance has emerged as a global public health problem, warranting an epidemic projection for this century.

Numerous studies have demonstrated differences in AF presentation, comorbidity burden, and admission rates between males and females. Therefore, it is critical to assess whether there are sex differences in adherence to and utilization of oral anticoagulants and outcomes based on hospital discharge status.^–

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ABCHF

Viewpoint

How to Anticoagulate Patients with Heart Failure and Cancer?

Marcos José Pereira Renni et al. Tatiana Abelin Saldanha Marinho

Conclusion

Anticoagulation in oncologic patients is a huge challenge, and we must always consider the risks and benefits of this management. However, with the prescription of DOACs, it becomes easier, safer, and more effective. When we individualize a patient’s therapy, according to the oncologic treatment, we can purpose the most appropriated strategy. We reinforce that, because of a high complex profile with several treatments, patients must be reevaluated periodically. In this way, we will further good medical practice.

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ABC

Original Article

Do cardiologists at a university hospital adopt the guidelines for the treatment of heart failure?

Antonio Carlos Pereira Barretto et al. Moacyr Roberto Cucê Nobre Inês Lancarotte Airton Roberto Scipioni José Antonio Franchini Ramires

OBJECTIVE: To verify whether the guidelines for the treatment of heart failure have been adopted at a university hospital. The guidelines recommend the following: use of angiotensin-converting enzyme inhibitors for all patients with systolic ventricular dysfunction, use of digitalis and diuretics for symptomatic patients, use of beta-blockers for patients in functional classes II or III, use of spironolactone for patients in functional classes III or IV. METHODS: We analyzed the prescriptions of 199 patients. All these patients had ejection fraction (EF) <=0.50, their ages ranged from 25 to 86 years, and 142 were males. Cardiomyopathy was the most frequent diagnosis: 67 (33.6%) patients had dilated cardiomyopathy, 65 (32.6%) had ischemic cardiomyopathy. RESULTS: Angiotensin-converting enzyme inhibitors were prescribed for 93% of the patients. 71.8% also had a prescription for digitalis, 86.9% for diuretics, 27.6% for spironolactone, 12% for beta-blockers, 37.2% for acetylsalicylic acid, 6.5% for calcium channel antagonists, and 12.5% for anticoagulants. In regard to vasodilators, 71% of the patients were using captopril (85.2mg/day), 20% enalapril (21.4mg/day), 3% hydralazine and nitrates. In 71.8% of the cases, the dosages prescribed were in accordance with those recommended in the large studies. CONCLUSION: Most patients were prescribed the same doses as those recommended in the large studies. Brazilian patients tolerate well the doses recommended in the studies, and that not using these doses may be a consequence of the physician's fear of prescribing them and not of the patient's intolerance.

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How to Improve Clinical Outcomes in Women with Atrial Fibrillation

Women and Atrial Fibrillation: Is the Disparity in Anticoagulation Just a Question of Gender? In Search of the Brazilian Reality

How to Anticoagulate Patients with Heart Failure and Cancer?

Conclusion

Do cardiologists at a university hospital adopt the guidelines for the treatment of heart failure?

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