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Published on: February 26, 2013
Current Status and Time Trends of Oral Anticoagulation Use Among Chinese Patients With Nonvalvular Atrial
San-Shuai Chang1, Jian-Zeng Dong2, Chang-Sheng Ma1
1From the Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Beijing, China (S.-S.C., J.-Z.D., C.-S.M., X.D., J.-H.W., R.-B.T., S.-J.X., X.-Y.G., R.-H.Y., D.-Y.L., R.B., N.L., C.-H.S., C.X.J., X.-H.L.); Biostatistics Department, Peking University Clinical Research Institute, Beijing, China (J.-H.P.); and University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom (G.Y.P.L.).
Background And Purpose:
Reported rates of oral anticoagulation (OAC) use have been low among Chinese patients with atrial fibrillation (AF). With improved awareness, changing guidelines, this situation may be changing over time. We aimed to explore the current status and time trends of OAC use in Beijing.
Methods:
We used the data set from the Chinese Atrial Fibrillation Registry (CAFR), a prospective, multicenter, hospital-based registry study involving 20 tertiary and 12 nontertiary hospitals in Beijing. A total of 11 496 patients with AF were enrolled from 2011 to 2014.
Results:
Seven thousand nine hundred seventy-seven eligible patients were included in this ancillary study. The proportions of OAC use were 36.5% (2268/6210), 28.5% (333/1168), and 21.4% (128/599) for patients with CHA2DS2-VASc scores ≥2, 1, and 0, respectively. Persistent AF, history of stroke/transient ischemic attack/peripheral embolism, diabetes mellitus, higher body mass index, and tertiary hospital management were factors positively associated with OAC use, whereas older age, previous bleeding, hypercholesterolemia, and established coronary artery disease were factors negatively associated with OAC use. Among patients with CHADS2 scores ≥2 and CHA2DS2-VASc scores ≥2, the proportion of OAC use increased from 31.3% to 64.5% and 30.2% to 57.7%, respectively, from 2011 to 2014. Variation in OAC use was substantial among different hospitals.
Conclusions:
An improvement of OAC use among Chinese patients with AF in Beijing is observed in recent years although only 36.5% of patients with CHA2DS2-VASc score ≥2 received OAC. However, variations between different hospitals were large, suggesting that better education and awareness are needed to improve efforts for stroke prevention among AF patients.
Clinical Trial Registration:
URL: http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729.
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