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脑卒中风险标准对非膜性心房的抗凝决定的影响:心房抗凝和风险因素研究 (ATRIA).

A S Go1, E M Hylek, K A Phillips

  • 1Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA. axg@dor.kaiser.org

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概括
此摘要是机器生成的。

不同的中风风险方案显著改变了对非膜动 (NVAF) 患者的华法林建议. 年龄是一个关键因素,更高的门可能会导致更多患者放弃抗凝药.

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科学领域:

  • 心脏病学 心脏病学
  • 神经学 神经学
  • 老年病的医生 老年病的医生

背景情况:

  • 华法林可降低非膜性心房动 (NVAF) 的中风风险,但可增加出血风险.
  • 准确识别需要抗凝血治疗的患者对于最佳的NVAF管理至关重要.
  • 脑卒中风险分类方案影响NVAF中的抗凝血决定.

研究的目的:

  • 评估突出的中风风险分类方案对NVAF患者抗凝决定的影响.
  • 以不同的标准来比较被归类为低中风风险的NVAF患者的比例.
  • 评估年龄值对NVAF中风风险评估的影响.

主要方法:

  • 利用临床和心电图数据库识别了13,559名门诊NVAF患者.
  • 使用心房研究人员 (AFI),美国胸部医生学院 (ACCP) 和心房研究人员中风预防 (SPAF) 的标准进行患者分类比较.
  • 分析了年龄 (65-75岁,>75岁) 和临床因素对中风风险分层的影响.

主要成果:

  • 根据AFI的标准,11%的NVAF患者被归类为中风风险低的患者.
  • 根据ACCP和SPAF标准分别将23%和29%的患者归类为中风风险较低的患者.
  • 通过ACCP和SPAF更高的分类率主要是由于包括没有额外的中风风险因素的老年人.

结论:

  • 增加中风风险的年龄门显著影响了NVAF对华法林的建议.
  • 需要进一步进行大规模的前性研究,以准确定义AF中与年龄相关的中风风险.
  • 确定足够低的中风风险以放弃抗凝药的NVAF亚组需要进一步的研究.