Characterization of patients with atrial fibrillation not treated with oral anticoagulants.
Characterization of patients with atrial fibrillation not treated with oral anticoagulants.
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DOI：
10.3109/02813432.2014.984952
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发表时间：
2014-12
影响因子：
2.1
通讯作者：
Jansson JH
中科院分区：
文献类型：
--
作者：
Johansson C;Hägg L;Johansson L;Jansson JH
Objective.房颤（AF）患者口服抗凝剂（OAC）使用不足，因为只有50%的AF患者接受OAC治疗。这是否是由于禁忌症，缺乏治疗适应症，或表达的使用不足是稀疏的调查。因此，本研究旨在描述AF患者真实人群中未接受OAC治疗的个体的特征。回顾性横断面研究。仔细检查病历，以确定AF的类型、栓塞和出血的风险因素以及OAC治疗的其他重要因素。设置.瑞典北方的阿勒夫特堡和诺斯约市。科目在2010年12月31日或之前，共有2274名至少有一次经证实的AF发作的在世居民。主要结果指标。OAC治疗的患病率和记录的暂停OAC治疗的原因。结果在所有2274例AF患者中，1187例（52%）未接受OAC治疗。在未接受治疗的患者中，19%的患者没有适应症或已经下降或经历了华法林治疗出血以外的不良反应。停用OAC的最常见原因是存在出血风险因素，在所有未经治疗的患者中有38%。此外，有75%的人可以确定拒绝OAC的书面原因。结论.在未接受OAC治疗的AF患者中，75%的患者可以确定暂停OAC治疗的原因。OAC的使用不足率估计为25%。
Objective. An underuse of oral anticoagulants (OAC) in patients with atrial fibrillation (AF) has been suggested, as only 50% of all patients with AF receive OAC treatment. Whether this is due to contraindications, lack of an indication to treat, or an expression of underuse is sparsely investigated. This study therefore aimed to characterize individuals without OAC treatment in a real-life population of patients with AF. Design. Retrospective cross-sectional study. The medical records were scrutinized in order to identify the type of AF, risk factors for embolism and bleeding, and other factors of importance for OAC treatment. Setting. The municipalities of Skellefteå and Norsjö, northern Sweden. Subjects. A total of 2274 living residents with at least one verified episode of AF on or before December 31, 2010. Main outcome measures. Prevalence of treatment with OAC and documented reasons to withhold OAC treatment. Results. Among all 2274 patients with AF, 1187 (52%) were not treated with OAC. Of the untreated patients, 19% had no indication or had declined or had experienced adverse effects other than bleeding on warfarin treatment. The most common reason to withhold OAC was presence of risk factors for bleeding, found in 38% of all untreated patients. Furthermore, a documented reason could be identified to withhold OAC in 75%. Conclusions. Among patients with AF without OAC treatment a reason could be identified to withhold OAC in 75%. The underuse of OAC is estimated to be 25%.
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作者：
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通讯作者：
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