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对未诊断的心房的查对预防中风的影响

Renato D Lopes¹, Steven J Atlas², Alan S Go³

¹Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.

Journal of the American College of Cardiology

|September 4, 2024

概括

使用14天监测器对老年人进行心房动 (AF) 查并没有减少中风住院的情况. 这项研究发现,查和通常护理组之间的中风或出血事件没有显著差异.

科学领域:

心脏病学心脏病学
预防医学预防医学
临床试验临床试验

背景情况:

未诊断的心房动 (AF) 显著增加缺血性中风风险.
口服抗凝药有效预防AF相关的中风.
之前的试验显示,随着更长的查,AF识别增加,但中风减少仍然没有得到证实.

研究的目的:

为了评估是否使用14天心电图监测器对70岁以上的个人进行AF查,可以减少中风.
确定AF查与口服抗凝药决策相结合是否提供与常规护理相比的净临床益处.

主要方法:

该GUARD-AF试验是一项前性,随机对照性研究.
参与者 (≥70岁) 被随机分配到14天的心电图监测或常规护理.
主要结局是中风住院和出血;使用治疗意图分析.

主要成果:

该研究招募了11,905名参与者,随访时间中位数为15.3个月.
在查组中,中风风险为0.7%,在常规护理组中为0.6% (HR:1.10).
出血风险为1.0%与1.1% (HR:0.87);在查组中,AF诊断率更高 (5%与3.3%).

结论:

在初级保健中使用14天心电图监测器查AF并没有减少70岁以上的个人中风住院的数量.
由于COVID-19的低发病率和低注册率影响了试验的功率.
可能需要进一步的研究来确定AF查对预防中风的有效性.

关键词:

心房动是心房动的一种.这是一种口服抗凝药.初级保健实践中的初级保健实践.查检查查检查查检查查检查一次性中风中风中风中风中风

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