Antithrombotic treatment in real-life atrial fibrillation patients:: a report from the Euro Heart Survey on Atrial Fibrillation
Antithrombotic treatment in real-life atrial fibrillation patients:: a report from the Euro Heart Survey on Atrial Fibrillation
复制标题
DOI：
10.1093/eurheartj/ehl015
复制
发表时间：
2006-12-01
影响因子：
39.3
通讯作者：
Crijns, Harry J. G. M.
中科院分区：
文献类型：
--
作者：
Nieuwlaat, Robby;Capucci, Alessandro;Crijns, Harry J. G. M.
目的描述不同卒中危险分层的指南依从性和应用。关于现实生活中心房抗血栓治疗的阳离子方案。房颤（AF）患者，并评估哪些因素影响抗血栓管理decisions.Methods和结果的欧洲心脏调查纳入5333 AF患者在35个国家，在2003年和2004年。抗血栓药物的处方，尤其是口服抗凝（OAC），很难适应患者的中风风险。如美国心脏病学会、美国心脏协会和欧洲心脏病学会联合指南、ACCP指南或CHADS（2）和Fragrance风险评分所示。在多变量分析中，只有有限数量的已知卒中危险因素触发OAC处方。相比之下，不太相关的因素，其中AF的临床类型和OAC监测门诊的可用性是最显著的，在OAC处方中起着重要作用。电复律和导管消融明确触发OAC处方，而药理学复律，即使在存在中风的危险因素没有。结论抗血栓治疗AF是很难适应患者的中风风险亲。乐除众所周知的卒中风险因素外，其他因素也显著影响抗血栓治疗决策。为了促进这种量身定制的治疗，指南作者和医生教育者应该专注于提供一个统一的和易于使用的中风风险分层。阳离子图式
Aims To describe guideline adherence and application of different stroke risk strati. cation schemes regarding antithrombotic therapy in real-life atrial. brillation (AF) patients and to assess which factors influence antithrombotic management decisions.Methods and results The Euro Heart Survey enrolled 5333 AF patients in 35 countries, in 2003 and 2004. Prescription of antithrombotic drugs, especially oral anticoagulation (OAC), was hardly tailored to the patient's stroke risk pro. le as indicated by the joint guidelines of the American College of Cardiology, American Heart Association, and the European Society of Cardiology, ACCP guidelines, or CHADS(2) and Framingham risk scores. In multivariable analysis, only a limited number of the well-known stroke risk factors triggered OAC prescription. In contrast, less relevant factors, of which clinical type of AF and availability of an OAC monitoring outpatient clinic were the most marked, played a significant role in OAC prescription. Electrical cardioversions and catheter ablations clearly triggered OAC prescription, whereas pharmacological cardioversions even in the presence of stroke risk factors did not.Conclusion Antithrombotic therapy in AF is hardly tailored to the patient's stroke risk pro. le. Factors other than well-known stroke risk factors were significantly involved in antithrombotic management decisions. To facilitate this tailored treatment, guideline writers and physician educators should focus on providing one uniform and easy to use stroke risk strati. cation scheme.