在心房动和心房动中评估中风预防治疗对心房动和心房动的潜在益处,使用一种新的竞争性风险评分工具
Anthony J Mazzella1, Thomas C Daubert1, Wanting Jin2
1Division of Cardiology, Department of Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA.
Journal of the American Heart Association
|February 3, 2026
概括
一个新的评分工具有助于识别老年心房的患者,他们最能从中风预防治疗中获益. 该工具通过将中风风险与非中风死亡风险进行比较,帮助共享决策.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 公共卫生 公共卫生
背景情况:
- 心房动 (AF) 患者面临非中风死亡的竞争风险,这可能会限制中风预防的好处.
- 确定真正受益于抗凝药的患者对于优化治疗策略至关重要.
研究的目的:
- 开发和验证一个评分工具来分层AF患者基于他们从血栓栓塞预防的潜在益处.
- 评估不同风险层中的中风风险与非中风死亡率.
主要方法:
- 使用ICD-9和ICD-10代码分析了一组医疗保险20%的AF患者样本队列 (2006-2019).
- 用精细回归和灰色回归和Cox比例危险分析来确定中风和非中风死亡风险.
- 一个新的评分工具将患者分为低或高的潜在益处组进行预防.
主要成果:
- 该研究包括330,136名AF患者 (平均年龄为79.7岁);64%的患者死亡,24%的患者在7.3年内发生了栓塞性中风.
- 在高益处组 (26.1%) 中,中风风险超过了1,3年和5年的非中风死亡风险.
- 在低益处组 (73.9%),非中风死亡风险在所有时间点显著超过中风风险.
结论:
- 一个拟议的评分工具有效地识别了可能受益于血栓栓塞性预防的老年AF患者.
- 这个工具可以支持临床医生和患者之间关于预防中风的共享决策.
- 需要进一步的研究来完善和验证这种评分工具的临床应用.
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