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Am Heart J:新发房颤患者使用口服抗凝药的情况因地而异?

2018-01-22 王淳 环球医学资讯

2017年12月,发表在《Am Heart J》的一项由英国、美国、德国、荷兰和加拿大科学家进行的研究,利用GARFIELD-AF、ORBIT-AF I和ORBIT-AF II注册库数据,考察了房颤患者的临床特征和口服抗凝治疗的国际趋势。

2017年12月,发表在《Am Heart J》的一项由英国、美国、德国、荷兰和加拿大科学家进行的研究,利用GARFIELD-AF、ORBIT-AF I和ORBIT-AF II注册库数据,考察了房颤患者的临床特征和口服抗凝治疗的国际趋势。

背景:房颤(AF)是世界范围内最常见的心律失常。本研究旨在提供有关AF卒中预防治疗国际模式的全面数据。

方法:对比GARFIELD-AF(n=51270)、ORBIT-AF I(n=10132)和ORBIT-AF II(n=11602)注册库中患者(来自35个国家,N=73004)的人口统计学、合并症和卒中风险。在新发病的AF患者(≤6周)中,评估卒中预防治疗。

结果:来自GARFIELD-AF患者中白种人较少(63% vs ORBIT-AF的89%和ORBIT-AF II的86%)或患有冠心病(19% vs 36%和27%),但具有相似的卒中风险(CHA2DS2-VASc≥2 :85% vs 91%和85%)和较低的出血风险(HAS-BLED≥3 :11% vs 24%和15%)。在GARFIELD-AF和ORBIT-AF II中,分别有46%和57%CHA2DS2-VASc=0的患者使用口服抗凝药,CHA2DS2-VASc≥2的有69%和87%,但在口服抗凝药的使用中存在很大的地域异质性(范围:31%~93% [GARFIELD-AF]和66%~100%[ORBIT-AF II])。在新发病的AF患者中,非维生素K拮抗剂口服抗凝药的使用随时间增加至2016年GARFIELD-AF的43%和ORBIT-AF II的71%,然而抗血小板单药疗法的使用从36%降至17%(GARFIELD-AF)和18%降至8%(ORBIT-AF I和II)。

结论:在新发病的AF患者中,非维生素K拮抗剂口服抗凝药的使用在增加而抗血小板单药疗法在降低。但是,抗凝药在低风险患者中被频繁使用,而在高卒中风险患者中不一致。抗凝药的明显地域差异仍然存在,这可能存在改善的机会。

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    2018-02-24 秀红

    学习了

    0

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    2018-01-24 zhaojie88
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    2018-01-24 slcumt
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