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Giornata mondiale contro l’ictus 2014 - I cardiologi chiedono maggior prevenzione, lavoro di “squadra” e terapie personalizzate

Ogni anno 6,2 milioni di persone muoiono per ictus, spesso causato da fibrillazione atriale non diagnosticata o non trattata con terapie adeguate. Un’indagine globale commissionata dalla Heart Rythm Society in partnership con Daiichi Sankyo, fotografa condizioni e sfide che i cardiologi di tutto il mondo affrontano ogni giorno nella gestione di questa patologia

 

Roma, 27 ottobre 2014 - Mercoledì 29 ottobre si celebrerà la X edizione della Giornata Mondiale contro l’ictus, attualmente la seconda più comune causa di morte nel mondo, responsabile approssimativamente di 6,2 milioni di decessi ogni anno. Una delle maggiori cause di ictus è la fibrillazione atriale, che ne aumenta da 3 a 5 volte il rischio e del 50 % il rischio di esito fatale e di disabilità conseguente.

La gestione dei pazienti affetti da fibrillazione atriale non valvolare è il centro di un’indagine globale iniziata quest’anno su cardiologi di tutto il mondo, da Harris Poll per conto della Heart Rythm Society in collaborazione con Daiichi Sankyo. La prima parte di questa ricerca ha coinvolto 1.100 specialisti provenienti da 7 Paesi: Brasile, Francia, Germania, Giappone, Spagna, Regno Unito e Stati Uniti.

Dai primi risultati risulta evidente che i pazienti affetti da fibrillazione atriale sono spesso diagnosticati in ritardo, e secondo la quasi totalità dei cardiologi (98%) ciò è dovuto principalmente all’asintomaticità (86%) e alla scarsa consapevolezza della malattia nei medici di medicina generale (40%) e nell’opinione pubblica (36%).

L’educazione diventa fondamentale, quindi, per sviluppare un approccio multidisciplinare di cura, gestione e prevenzione della malattia e delle sue potenziali conseguenze, l’84 % degli intervistati crede infatti che un coordinamento tra diversi team specializzati sia necessario, eppure solo 1 su 3 ritiene che questo sia realizzato in modo adeguato, mentre gli altri chiedono un maggior impegno da parte di tutte le figure sanitarie coinvolte, inclusi i caregiver, nella gestione dei pazienti, soprattutto quando presentano condizioni di comorbilità.

Per prevenire l’ictus nei pazienti affetti da fibrillazione atriale sono disponibili diversi trattamenti anticoagulanti, eppure un paziente su tre di coloro i quali presentano un livello di rischio tale da giustificare l’assunzione di questa terapia secondo le attuali linee guida, non la riceve. Ciò avviene soprattutto per il rifiuto del paziente, l'alto rischio di sanguinamento e la presenza di controindicazioni.

Secondo il sondaggio, sono i 3 fattori principali che i cardiologi considerano nella decisione di somministrare terapia anticoagulante: il rischio di emorragia per i pazienti, l’anamnesi di ictus emorragico e la compliance. Nella scelta della tipologia di terapia anticoagulante, il fattore più importante è invece il profilo di efficacia complessivo del farmaco.

La maggioranza dei cardiologi (58%) concorda, inoltre, sul fatto che non esiste una manifestazione “tipica” di fibrillazione atriale, e per l'88% di loro ogni paziente è diverso, perciò sarebbe opportuno concentrarsi su caratteristiche e comorbilità di ciascuno, per un'adeguata gestione della malattia attraverso un approccio personalizzato.