摘要
目的分析2014年心房顫動(atrial fibrillation,AF)診療管理指南更新對高危栓塞風險的非瓣膜病心房顫動(non-valvular atrial fibrillation,NVAF)患者抗凝治療率和治療方案的影響,為臨床抗凝管理提供依據。方法選取本院2010年1月1日~2018年12月31日期間高危栓塞風險NVAF患者納入研究,收集臨床資料和抗凝治療情況,以2014年AF診療管理指南頒佈為界點分為:研究組(指南頒佈後)和對照組(指南頒佈前),比較兩組抗凝治療率和治療藥物的變化。結果研究人群的平均抗凝治療率為26.69±11.27%,研究觀察期間按年上升趨勢,2018年抗凝治療率比2010年增長超過3倍(43.62%vs.12.73%)。研究組抗凝治療率較對照組明顯上升(37.37%vs.18.05%,P=0.023)。抗凝藥物方面,研究組使用非維生素K拮抗劑口服抗凝藥(non-vitamin K antagonist anticoagulants,NOACs)治療的比例比對照組增加了近10倍(20.72%vs.2.27%,P=0.014),而兩組華法林治療比例無明顯變化(16.65%vs.15.78%,P=0.624)。結論AF診療管理指南的更新和頒佈顯著提高了高危栓塞風險的NVAF抗凝治療率,有助於臨床醫生對該類患者進行規範化抗凝管理。
Objective This analysis aimed to assess the impact of the updated 2014 Atrial fibrillation(AF)diagnosis and management guidelines on the anticoagulation therapy rate and treatment plans for high-risk thromboembolism non-valvular atrial fibrillation(NVAF)patients.The results of this study can provide evidence-based guidance for clinical anticoagulation management.Methods This study included high-risk thromboembolism NVAF patients at Kiang Wu Hospital between January 1,2010,and December 31,2018.Clinical data and anticoagulation therapy information were collected.The study population was divided into two groups based on the publication of the 2014 AF diagnosis and management guidelines:the study group(after publication)and the control group(before publication).The anticoagulation therapy rate and medication changes between the two groups were compared.Results The average anticoagulation therapy rate for the study population was 26.69±11.27%,and there was an increasing trend observed annually during the study period.In 2018,the anticoagulation therapy rate increased more than three-fold compared to that in 2010(43.62%vs.12.73%).The study group had a significantly higher anticoagulation therapy rate than the control group(37.37%vs.18.05%,P=0.023).With regard to anticoagulant drugs,the proportion of patients in the study group treated with non-vitamin K antagonist anticoagulants(NOACs)increased nearly 10-fold compared to that in the control group(20.72%vs.2.27%,P=0.014),while the proportion of patients receiving warfarin therapy showed no significant change between the two groups(16.65%vs.15.78%,P=0.624).Conclusion The updated guidelines for treating atrial fibrillation have helped improve the rate of anticoagulation therapy for high-risk thromboembolism in patients with non-valvular atrial fibrillation.This promotes a more standardized and efficient approach to anticoagulation management for NVAF patients among clinical physicians.
作者
柯于梵
陳劍
蕭湛潮
李惠潔
羅卓恩
鍾桃娟
O U Fan;CHAN Jian;SIO Cham Chio;LEI Wai Kit;LO Cheok Ian;CHONG Tou Kun(Department of Cardiology,Kiang Wu Hospital,Macao,china;Department of Cardiology,Cardiovascular Centre,The Fifth Affiliated Hospital of Sun Yat-sen University,Zhuhai,Guangdong Province,China)
出处
《镜湖医学》
2023年第1期39-42,35,共5页
MEDICAL JOURNAL OF KIANG WU
关键词
抗凝治療
非瓣膜病心房顫動
華法林
非維生素K拮抗劑口服抗凝藥
Oral anticoagulation therapy
Non-valvular atrial fibrillation
Warfarin
Non-vitamin K antagonist anticoagulants
