在初级保健诊所对老年人进行心房动的查:VITAL-AF随机对照试验
Steven A Lubitz1,2, Steven J Atlas3, Jeffrey M Ashburner3,2
1Demoulas Center for Cardiac Arrhythmias and Cardiovascular Research Center (S.A.L., S.K., P.T.E.), Massachusetts General Hospital, Boston.
Circulation
|March 2, 2022
概括
在初级护理中使用手持心电图进行心房动 (AF) 的临床查并没有增加65岁以上患者的AF新诊断. 需要对老年人进行进一步的研究.
科学领域:
- 心脏病学
- 主要护理医学
- 医疗器械
背景情况:
- 没有确诊的心房动 (AF) 存在可预防性中风的风险.
- 目前的AF查指南缺乏共识.
- 这项研究解决了在初级保健机构中有效的AF检测策略的需求.
研究的目的:
- 在初级保健诊所使用手持单导电心电图来评估AF诊所查的有效性.
- 确定这种查方法是否增加了65岁及以上患者的AF诊断.
主要方法:
- 一项涉及16家初级保健诊所的随机对照试验.
- 65岁以上的患者被随机分配到手持心电图或常规护理的AF查中.
- 在1年的随访期间确定了新的AF诊断.
主要成果:
- 在查和常规护理组之间,新的AF诊断没有显著差异 (1.72%对1.59%).
- 在85岁以上的查组中观察到新的AF诊断的发病率较高 (5. 56%对比3. 76%).
- 在两组新诊断的AF患者中,口服抗凝剂的发病率相似.
结论:
- 在初级护理中,用手持心电图进行治疗地点的查并没有增加65岁以上的AF新诊断.
- 在较老的子组 (≥85岁) 中,查可能更有益.
- 这项研究没有发现两组之间口服抗凝剂的启动率有差异.
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