首页|Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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  • 国家科技期刊平台
  • NETL
  • NSTL
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Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.Methods:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guide-line-recommended OAC use in eligible patients was assessed.Results:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low risk.On admission,only 20.0％(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking OAC.The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95％confidence interval:0.43-0.68;P＜0.001).At discharge,the prescription rate of OAC was 45.2％(16,757/37,087)in eligible patients with high stroke risk and 60.7％(2778/4578)in eligible patients with low stroke risk.OAC utilization in patients with high stroke risk on admission or at discharge both increased largely over time(all P＜0.001).Multivariate analysis showed that OAC utilization at discharge was positively associated with in-hospital rhythm control strategies,including catheter ablation(adjusted odds ratio[OR]11.63,95％confidence interval[CI]10.04-13.47;P＜0.001),electronic cardioversion(adjusted OR 2.41,95％CI 1.65-3.51;P＜0.001),and anti-arrhythmic drug use(adjusted OR 1.45,95％CI 1.38-1.53;P＜0.001).Conclusions:In hospitals participated in the CCC-AF project,＞70％of AF patients were at a high risk of stroke.Although poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.

Atrial fibrillationOral anti-coagulantsOACStroke preventionContraindication

Jing Lin、Deyong Long、Chenxi Jiang、Caihua Sang、Ribo Tang、Songnan Li、Wei Wang、Xueyuan Guo、Man Ning、Zhaoqing Sun、Na Yang、Yongchen Hao、Jun Liu、Jing Liu、Xin Du、Louise Morgan、Gregg C.Fonarow、Sidney C.Smith Jr、Gregory Y.H.Lip、Dong Zhao、Jianzeng Dong、Changsheng Ma、On behalf of CCC-AF investigators

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Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China

National Clinical Research Center for Cardiovascular Diseases,Beijing 100029 China

Department of Epidemiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China

International Quality Improvement Department,American Heart Association,Dallas,TX 07076,USA

Division of Cardiology,Geffen School of Medicine at University of California,Los Angeles CA 90024,USA

Division of Cardiology,University of North Carolina,Chapel Hill,NC 27599,USA

Department of Cardiology,Liverpool Centre for Cardiovascular Science,University of Liverpool and Liverpool Heart & Chest Hospital,Liverpool L143PE,UK

Department of Clinical Medicine,Aalborg University,Aalborg 9000,Denmark

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2024

10.1097/CM9.0000000000002915

中华医学杂志(英文版)
中华医学会

中华医学杂志(英文版)

CSTPCD
影响因子：0.838
ISSN：0366-6999
年,卷(期)：2024.137(2)
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