Evaluar mediante indicadores asistenciales las diferencias por sexo y el manejo de los problemas clínicos que presentan los pacientes que presentan fibrilación auricular. Durante 5 meses se incluyó consecutivamente a todos los pacientes atendidos en las consultas de cardiología de 2 hospitales de tercer nivel por presentan un episodio de fibrilación auricular o un proceso clínico debido a ella. Se incluyó a 533 pacientes (el 56,5% mujeres; media de edad, 70,5 ± 12,2 años), de los que el 24,3% eran menores de 65 años. Las mujeres tenían significativamente más problemas clínicos y un riesgo de embolia más elevado: CHADS2 (insuficiencia cardiaca congestiva, hipertensión, edad, diabetes, ictus [doble]) (1,8 ± 1,2 frente a 1,5 ± 1,1; p = 0,001) y CHA2DS2-VASc (insuficiencia cardiaca congestiva, hipertensión, edad ≥ 75 [doble], diabetes, ictus [doble], enfermedad vascular y categoría de sexo [mujeres]) (3,7 ± 1,4 frente a 2,2 ± 1,4; p = 0,0001). Al 94% de los pacientes se los derivaba correctamente a cardiología, el 53,8% procedía de atención primaria u otros servicios del hospital y al 93,4% se le realizó o indicó una ecocardiografía. El tratamiento (antiarrítmico y antiembolígeno) se hace según las recomendaciones de las guías. El índice de Rosendaal en los 3 meses previos fue de 48,4 ± 37,4. Uno de cada 4 pacientes que consultan por problemas derivados de la fibrilación auricular son jóvenes y las mujeres tienen más problemas clínicos y consultan más. A los pacientes se los deriva correctamente a cardiología, y la mayoría no procede de urgencias. Se indican la ecocardiografía y el tratamiento antiarrítmico y antiacoagulante tal como recomiendan las guías de práctica clínica. El control de la anticoagulación con fármacos antagonistas de la vitamina K es deficiente. To assess sex differences and the management of clinical problems in patients with atrial fibrillation through the use of care indicators. Over a 5-month period, the study included all consecutive patients attended in the cardiology outpatient clinics of 2 tertiary hospitals with an atrial fibrillation episode or a clinical process due to atrial fibrillation. A total of 533 patients were included (56.5% women; mean age, 70.5 ± 12.2 years), of whom 24.3% were younger than 65 years. Women had significantly more clinical problems and a higher stroke risk: CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke [doubled]) (1.8 ± 1.2 vs 1.5 ± 1.1; P = .001) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥ 75 [doubled], diabetes, stroke [doubled]-vascular disease and sex category [female]) (3.7 ± 1.4 vs 2.2 ± 1.4; P = .0001). Referrals to the cardiology department were appropriate in 94% of the patients, the referral source was primary care or other hospital services in 53.8%, and echocardiography was performed or recommended in 93.4%. Treatment (antiarrhythmics and anticoagulants) was administered according to guideline recommendations. In the previous 3 months, the Rosendaal index was 48.4 ± 37.4. One in every 4 patients seeking care for problems associated with atrial fibrillation are young; women have more clinical problems and seek care more frequently than men. Patients are correctly referred to the cardiology department and most are not referred from the emergency department. Echocardiography and antiarrhythmic and anticoagulant therapy were provided according to the recommendations of clinical practice guidelines. Vitamin K antagonists for anticoagulation therapy are underused. Full English text available from: www.revespcardiol.org/en

Introduction and Objectives: To assess sex differences and the management of clinical problems in patients with atrial fibrillation through the use of care indicators.Methods: Over a 5-month period, the study included all consecutive patients attended in the cardiology outpatient clinics of 2 tertiary hospitals with an atrial fibrillation episode or a clinical process due to atrial fibrillation.Results: A total of 533 patients were included (56.5% women; mean age, 70.5 +/- 12.2 years), of whom 24.3% were younger than 65 years. Women had significantly more clinical problems and a higher stroke risk: CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke [doubled]) (1.8 +/- 1.2 vs 1.5 +/- 1.1; P = .001) and CHA(2)DS(2)-VASc (congestive heart failure, hypertension, age >= 75 [doubled], diabetes, stroke [doubled]-vascular disease and sex category [female]) (3.7 +/- 1.4 vs 2.2 +/- 1.4; P = .0001). Referrals to the cardiology department were appropriate in 94% of the patients, the referral source was primary care or other hospital services in 53.8%, and echocardiography was performed or recommended in 93.4%. Treatment (antiarrhythmics and anticoagulants) was administered according to guideline recommendations. In the previous 3 months, the Rosendaal index was 48.4 +/- 37.4.Conclusions: One in every 4 patients seeking care for problems associated with atrial fibrillation are young; women have more clinical problems and seek care more frequently than men. Patients are correctly referred to the cardiology department and most are not referred from the emergency department. Echocardiography and antiarrhythmic and anticoagulant therapy were provided according to the recommendations of clinical practice guidelines. Vitamin K antagonists for anticoagulation therapy are underused. (C) 2015 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

La fibrilación auricular (FA) es una patología muy prevalente que motiva un elevado número de consultas en los servicios de cardiología. El objetivo de nuestro trabajo es describir las características clínicas de los pacientes que padecen FA atendidos en las consultas de cardiología, el tratamiento antiarrítmico y antitrombótico prescrito por los cardiólogos, y comparar los datos con las recomendaciones de las guías de práctica clínica europeas (GPCE) de FA de 2010. . Analizamos a los pacientes atendidos en las consultas de cardiología de nuestro hospital durante 2 semanas consecutivas de septiembre de 2010. Se recogieron las características clínicas de los pacientes, el tipo de FA que presentaban, el tratamiento farmacológico, y se determinó el riesgo de embolia según diferentes criterios utilizados por las GPCE. De los 759 pacientes atendidos, 160 (21%) presentaban o habían presentado una FA, y fueron incluidos en el registro. Treinta y dos pacientes (20%) era <65 años y 137 padecían FA no valvular. Existen diferencias entre hombres y mujeres en la prevalencia de dislipidemia (49,4 vs 31,6%, p = 0,02), tabaquismo (14,8 vs 3,1%, p = 0,01), valvulopatía (6,2 vs 22,8%, p = 0,003), edad (p = 0,05), arteriopatía periférica (37 vs 8,9%, p = 0,0001), en el ritmo que presentaba el ECG (p = 0,01) y en el tipo de FA (p = 0,05) y en la edad de aparición de estas (p = 0,002), pero no había diferencias en el tratamiento utilizado. Estaban anticoagulados 95 pacientes y se anticoagulaban un 64% con valor CHADS2 ≥2, mientras que solo un 50% con CHA2DS2VASc ≥2. . En nuestras consultas uno de cada 5 pacientes con FA es un paciente joven, la indicación de ACO en los pacientes con FA se va a incrementar y el tratamiento anticoagulante realizado por los cardiólogos se adhiere al recomendado por las guías, pero siguen existiendo discrepancias significativas. Atrial fibrillation (AF) is a prevalent condition that leads to a high number of consultations in clinical practice. The aim of our study is to describe the clinical characteristics of patients with AF treated in the cardiology clinic, to evaluate how cardiologists treat these patients and whether prevention of stroke performed in routine clinical practice is according to the antithrombotics criteria recommended by the 2010 European clinical practice guidelines (ECPG) in AF. We analysed all patients evaluated in the cardiology clinic for two consecutive weeks during September 2010. We collected the clinical characteristics of patients, the type of AF, drug treatment, and determined the risk of stroke according to different criteria used by the ECPG. Of the 759 patients treated, 160 (21%) had AF, and were included in the registry. Thirty-two patients (20%) were <65 years and 137 suffered non-valvular AF. Sex differences were observed in prevalence of dyslipidaemia (49.4% vs 31.6%, P = .02), smoking (14.8% vs 3.1%, P = .01), valve disease (6.2% vs 22.8%, P = .003), age (P = .05), peripheral arterial disease (37% vs 8.9%, P = .0001), in the rhythm in the ECG (P = .01) and the type of AF (P = .05) and age of these (P = .002), but there were no differences in the treatment used. Ninety five patients were anticoagulated, but only 64% of patients with CHADS2 ≥2, and 50% with CHA2DS2VASc ≥2. One out of every 5 patients with AF evaluated in our clinics are under 65 years. The indication for anticoagulant treatment will probably increase in the next few years. The adherence to the recommendations for anticoagulation of the ECPG is good, but could be improved.