Real-life experience with non-vitamin K antagonist oral anticoagulants versus warfarin in patients undergoing elective cardioversion of atrial fibrillation.
Real-life experience with non-vitamin K antagonist oral anticoagulants versus warfarin in patients undergoing elective cardioversion of atrial fibrillation.
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DOI：
10.1111/anec.12766
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Lehto M
中科院分区：
文献类型：
--
作者：
Itäinen-Strömberg S;Hekkala AM;Aro AL;Vasankari T;Airaksinen KEJ;Lehto M
非维生素K拮抗剂口服抗凝剂（NOACs）越来越多地用于心房颤动（AF）患者进行选择性心律转复（ECV）。目的是调查在现实生活中使用NOACs和华法林治疗ECV，并评估所选择的方案如何影响ECV的延迟和并发症的发生率。研究了2015年1月至2016年12月在赫尔辛基城市医院连续接受ecv的房颤患者。评估患者特征、转复延迟、抗凝治疗、急性（<30天）并发症和一年内方案改变的数据。900例患者（男性59.2%，平均年龄68.0±10.0岁）接受了992次ecv，其中596例（60.0%）采用noac， 396例（40.0%）采用华法林。平均CHA2DS2 - VASc评分为2.5（±1.6）。在既往未接受过抗凝治疗的患者中，NOACs与华法林相比，到心脏复律的平均时间更短。分别68天；p < 0.001)。发生6起血栓栓塞事件（0.6%）：NOAC治疗的患者发生4起（0.7%），华法林治疗的患者发生2起（0.5%）。接受华法林治疗的7例患者（1.8%）和接受NOACs治疗的3例患者（0.5%）发生了临床相关出血事件。在研究期间，99例患者（11.0%）改变了抗凝治疗，其中大多数（88.2%）从华法林改为NOACs。在这项现实生活的研究中，接受ECV的房颤患者血栓栓塞和出血并发症的发生率很低。接受NOAC治疗的患者比接受华法林治疗的患者转心时间更短，继续抗凝治疗的频率更高。
Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used in patients with atrial fibrillation (AF) undergoing elective cardioversion (ECV). The aim was to investigate the use of NOACs and warfarin in ECV in a real‐life setting and to assess how the chosen regimen affected the delay to ECV and rate of complications. Consecutive AF patients undergoing ECVs in the city hospitals of Helsinki between January 2015 and December 2016 were studied. Data on patient characteristics, delays to cardioversion, anticoagulation treatment, acute (<30 days) complications, and regimen changes within one year were evaluated. Nine hundred patients (59.2% men; mean age, 68.0 ± 10.0) underwent 992 ECVs, of which 596 (60.0%) were performed using NOACs and 396 (40.0%) using warfarin. The mean CHA2DS2‐VASc score was 2.5 (±1.6). In patients without previous anticoagulation treatment, NOACs were associated with a shorter mean time to cardioversion than warfarin (51 versus. 68 days, respectively; p < .001). Six thromboembolic events (0.6%) occurred: 4 (0.7%) in NOAC‐treated patients and 2 (0.5%) in warfarin‐treated patients. Clinically relevant bleeding events occurred in seven patients (1.8%) receiving warfarin and three patients (0.5%) receiving NOACs. Anticoagulation treatment was altered for 99 patients (11.0%) during the study period, with the majority (88.2%) of changes from warfarin to NOACs. In this real‐life study, the rates of thromboembolic and bleeding complications were low in AF patients undergoing ECV. Patients receiving NOAC therapy had a shorter time to cardioversion and continued their anticoagulation therapy more often than patients on warfarin.
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影响因子：
39.3
作者：
Ezekowitz MD;Pollack CV Jr;Halperin JL;England RD;VanPelt Nguyen S;Spahr J;Sudworth M;Cater NB;Breazna A;Oldgren J;Kirchhof P
通讯作者：
Kirchhof P
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作者：
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影响因子：
11.1
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
10.4
作者：
Gorst-Rasmussen, A.;Skjoth, F.;Lane, D. A.
通讯作者：
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