Sun Yihong, Hu Dayi
Heart Center of Peking University People's Hospital, Beijing 100044, China.
Heart Center of Peking University People's Hospital, Beijing 100044, China. Email:
Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Oct;42(10):846-50.
To describe the baseline characteristics and antithrombotic treatment of patients with non-valvular atrial fibrillation in the Chinese subgroup of GRAFIELD.
GARFIELD is an observational registry study for patients with newly diagnosed non-valvular atrial fibrillation. A total of 805 adult ( ≥18 years old) patients (mean age: (66.6 ± 11.4) years old, 39.4% female (n = 317)) diagnosed with non-valvular atrial fibrillation within the previous 6 weeks were recruited between December 2009 and October 2011 at 29 hospitals from China. Baseline data included demographics, medical history, nature of atrial fibrillation, CHA(2)DS(2) score, CHA(2)DS(2)-VASc score, and treatment at the time of diagnosis.
There were 216 patients (26.8%) with age above 75 years old, 116 patients (14.4%) had history of stroke or TIA, 261 patients (32.4%) had coronary artery disease. Mean CHADS(2) score was 1.7 ± 1.1, and 391 patients (48.5%) had a CHADS(2) score ≥ 2. Mean CHA(2)DS(2)-VASc score was 2.9 ± 1.7, and 630 patients (78.3%) had a CHA(2)DS(2)-VASc score ≥ 2.Overall, 159 patients (19.8%) received no anticoagulant treatment, 51.6% (n = 415) patients received aspirin and only 28.7% (n = 231) patients received either warfarin (n = 179, 22.2%) or new oral anticoagulants (NOAC) (n = 52, 6.5%). Among patients with CHADS2 score ≥ 2 (n = 391), 68.3% patients (n = 267) did not receive anticoagulant therapy. Among patients with CHA(2)DS(2)-VASc ≥ 2 (n = 630), 71.7% (n = 452) did not receive anticoagulant therapy. For the patients with very high risk of stroke, i.e. CHA(2)DS(2)-VASc ≥ 6, the proportion of the patients received NOAC and warfarin were identical (14.9%, 7/47).
This contemporary observational registry study shows that the anticoagulant therapy is somehow improved but still underused in Chinese NVAF patients. Stroke prevention according to risk scores and current guidelines in these patients remains an important task in China.
描述GRAFIELD研究中国亚组中非瓣膜性心房颤动患者的基线特征及抗栓治疗情况。
GARFIELD是一项针对新诊断非瓣膜性心房颤动患者的观察性登记研究。2009年12月至2011年10月期间，在中国29家医院招募了805例（年龄≥18岁）在过去6周内被诊断为非瓣膜性心房颤动的成年患者（平均年龄：（66.6±11.4）岁，女性占39.4%（n = 317））。基线数据包括人口统计学信息、病史、心房颤动类型、CHA(2)DS(2)评分、CHA(2)DS(2)-VASc评分以及诊断时的治疗情况。
年龄在75岁以上的患者有216例（26.8%），有卒中或短暂性脑缺血发作病史的患者有116例（14.4%），有冠状动脉疾病的患者有261例（32.4%）。平均CHADS(2)评分为1.7±1.1，391例（48.5%）患者的CHADS(2)评分≥2。平均CHA(2)DS(2)-VASc评分为2.9±1.7，630例（78.3%）患者的CHA(2)DS(2)-VASc评分≥2。总体而言，159例（19.8%）患者未接受抗凝治疗，51.6%（n = 415）的患者接受了阿司匹林治疗，仅28.7%（n = 231）的患者接受了华法林（n = 179，22.2%）或新型口服抗凝药（NOAC）（n = 52，6.5%）治疗。在CHADS2评分≥2的患者（n = 391）中，68.3%（n = 267）的患者未接受抗凝治疗。在CHA(2)DS(2)-VASc≥2的患者（n = 630）中，71.7%（n = 452）的患者未接受抗凝治疗。对于卒中极高风险患者，即CHA(2)DS(2)-VASc≥6的患者，接受NOAC和华法林治疗的患者比例相同（14.9%，7/47）。
这项当代观察性登记研究表明，中国非瓣膜性心房颤动患者的抗凝治疗虽有所改善，但仍未得到充分应用。根据风险评分和现行指南对这些患者进行卒中预防在中国仍是一项重要任务。
