在设备检测到心房后,抗凝药处方和结果的实践变化
在PubMed上查看摘要
概括
此摘要是机器生成的。口服抗凝药 (OAC) 在设备检测到的心房动 (AF) 中未得到充分利用,尽管与中风风险降低有关. 较高的AF负担,特别是在24小时内,显示OAC的中风减少最强.
科学领域
- 心脏病学
- 医疗器械
- 公共卫生
背景情况
- 设备检测到的心房动 (AF) 增加了中风风险,但缺乏基于AF负担的口服抗凝药 (OAC) 的明确指导方针.
- 了解设备检测AF后的OAC处方模式对于优化中风预防策略至关重要.
研究的目的
- 在新设备检测到的AF后,调查OAC处方实践的变化.
- 通过不同AF负担的门来检查OAC启动和中风风险之间的关联.
主要方法
- 使用与远程监测相关的退伍军人健康管理局数据进行回顾性队列研究.
- 包括心脏植入式电子设备的患者和AF负担数据 (2011-2014).
- 在AF检测后90天内分析OAC处方,并使用Cox回归来分析其与中风的关联.
主要成果
- 设备检测的AF是常见的,在很大一部分患者中观察到显著的AF负担.
- OAC的处方率随着AF负担的增加而增加,但总体上仍然很低 (超过6分钟的13%,超过24小时的27%).
- 在OAC处方中发现了显著的位点水平变化;AF开始后的24小时与中风风险的显著降低有关.
结论
- 在心脏植入式电子设备的退伍军人中, 设备检测的AF很普遍.
- 在OAC开始时存在显著的实践差异,即使在长期的AF发作中,整体治疗率也很低.
- 需要进一步的随机试验来证实OAC在设备检测的AF中降低中风的益处.
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