Clinical investigationCost of care distribution in atrial fibrillation patients: the COCAF study
Section snippets
Population
A group of 671 patients with AF were recruited during 1 year by 82 cardiologists distributed in all regions of France. They were consecutive patients seen by these cardiologists, without particular inclusion or exclusion criteria and regardless of the duration of AF. The cardiologists were randomly selected, and the number of cardiologists recruited in a given region was weighted by the number of inhabitants. The number of recruited patients was limited to 12 per cardiologist.
Among these
Clinical characteristics of the patients
The mean blood pressure of these patients was 139/81, their mean heart rate was 67 bpm. In patients with PAAF, the mean heart rate was 71 bpm in sinus rhythm (86 bpm during AF episodes). In the PEAF group, the mean heart rate was higher: 80 bpm in AF.
A large majority of these patients (78% with PAAF and 84% with PEAF) were suffering from concomitant diseases at inclusion: hypertension in 43% of patients, heart failure in 16%, coronary artery disease in 13%, and valvular heart disease in 13%.
Discussion
The main finding of this large survey is that hospitalizations represent the major cost driver in cost of care for AF patients. The population we have studied is very close to that of the Etude en Activité Libeiale de la Fibrillation Auriculaire (ALFA) study.6 It demonstrates a shift toward nonrheumatic AF. Underlying heart disease was present in a large proportion of patients (78% in PAAF and 84% in PEAF). Hypertension was the most common underlying condition (43%). This high proportion is
Acknowledgements
We thank E. Tarral, C. Durieux, P. Ngo, and the 82 cardiologists who have participated to the study for their help.
References (23)
- et al.
Prevalence, incidence, prognosis and predisposition for atrial fibrillationpopulation-based estimates
Am J Cardiol
(1998) - et al.
Decision analysis and guidelines for anticoagulant therapy to prevent stroke in patients with atrial fibrillation
Lancet
(2000) - et al.
Cost effectiveness of inpatient initiation of antiarrhythmic therapy for supraventricular tachycardias
Am J Cardiol
(1997) - et al.
Second line pharmacological management of paroxysmal and persistent atrial fibrillation in Francea cost analysis
Value Health
(2000) - et al.
Acute treatment of atrial fibrillationspontaneous conversion rate and cost of care
Am J Cardiol
(1999) - et al.
Impact of atrial fibrillation on the risk of deaththe Framingham Heart Study
Circulation
(1998) - et al.
Decrease in mortality in patients with an hospital diagnosis of atrial fibrillation in Denmark during the period 1980-1993
Eur Heart J
(1999) - Caisse Nationale d'Assurance Maladie des Travailleurs Salariés (CNAMTS). Carnets statistiques 1996 n°81. Le secteur...
- Union des Caisses Nationales de Sécurité Sociale (UCANSS). Nomenclature générale des actes professionnels,...
- et al.
Characterization of different subsets of atrial fibrillation in general practice in Francethe ALFA study
Circulation
(1999)
Trends in hospital activity, morbidity and case fatality related to atrial fibrillation in Scotland, 1986-1996
Eur Heart J
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