Kaya Hasan, Ertaş Faruk, Kaya Zekeriya, Kahya Eren Nihan, Yüksel Murat, Köroğlu Bayram, Köse Nuri, Yıldız Abdulkadir, Cimen Tolga, Ulgen Mehmet Sıddık
Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Cardiol J. 2014;21(2):158-62. doi: 10.5603/CJ.a2013.0085. Epub 2013 Jun 25.
The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study.
Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis.
The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF.
Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism.
本研究旨在基于土耳其心房颤动：流行病学登记（AFTER）研究记录，对瓣膜性心房颤动（AF）患者的流行病学、当前治疗性抗凝效果及血栓栓塞风险进行多中心前瞻性调查。
从通过心电图诊断为AF的2242例连续入院患者中选取研究对象。非瓣膜性AF患者被排除在AFTER研究人群之外，最终留下497例瓣膜性AF患者进行分析。
瓣膜性AF患者的病因要么归因于风湿性二尖瓣狭窄（n = 217），要么是有人工心脏瓣膜（n = 280）。在所有瓣膜性AF患者中，83.1%正在服用华法林进行抗凝。只有36.1%的患者国际标准化比值（INR）达到治疗水平，且在这些患者中发现19.1%的患者INR不稳定。多因素分析显示，年龄是瓣膜性AF患者血栓栓塞事件的唯一独立预测因素。
许多瓣膜性AF患者的INR未维持在治疗水平，随着年龄增长，这对患者健康构成威胁，且其血栓栓塞风险更高。
