用心电图检查心房动:美国预防服务工作组建议声明
, Susan J Curry1, Alex H Krist2,3
1University of Iowa, Iowa City.
JAMA
|August 9, 2018
概括
使用心电图 (ECG) 查老年人心肌动 (AF) 没有足够的证据来确定其净益处. 美国预防服务特别工作组发现,虽然肌痛性肌痛增加了中风风险,但查和治疗的危害超过了已证明的好处.
科学领域:
- 心脏病学
- 预防医学
- 公共卫生
背景情况:
- 心房动 (AF) 是最常见的心律失常,随着年龄的增长,患病率显著增加.
- 是缺血性中风的主要危险因素,
- 大约20%的中风患者在中风时被诊断出患有中风.
研究的目的:
- 为美国预防服务工作组 (USPSTF) 关于使用心电图 (ECG) 查心房动 (AF) 的新建议提供信息.
主要方法:
- 在65岁及以上的成年人中,USPSTF系统审查了对心电图查的益处和危害的证据.
- 评估了心电图查与常规护理在检测未诊断的关节炎方面的有效性.
- 评估抗凝固剂或抗血小板疗法的益处和危害.
主要成果:
- 大多数未诊断的老年人患有中风风险,需要抗凝药治疗.
- 在具有高风险的有症状的AF患者中,抗凝药疗法有效预防中风.
- 没有足够的证据来证实心电图查和随后的治疗是否改善了无症状成年人的治疗结果.
结论:
- 在65岁及以上的成年人中,USPSTF发现没有足够的证据来评估查心房动的益处与危害.
- 潜在的危害包括错误诊断和侵入性后续检测.
- 对心电图查的净益仍然不确定.
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