Račkauskas Gediminas, Zabiela Vytautas, Marinskis Germanas, Baranauskas Arvydas, Balkutė Deimilė, Alunderytė Justina, Puodžiūkynas Aras, Kazakevičius Tomas, Kviesulaitis Vilius, Aidietis Audrius
Centre for Cardiology and Angiology, Department of Cardiovascular Diseases, Vilnius University, Vilnius, Lithuania.
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Medicina (Kaunas). 2017;53(1):19-25. doi: 10.1016/j.medici.2017.01.005. Epub 2017 Feb 20.
The aim of this study to investigate the most frequent risk factors of atrial fibrillation (AF), co-morbidities, complications associated with AF and the use of anticoagulants and other medications in patients who were referred to university hospitals in Lithuania.
This cross-sectional study enrolled consecutive inpatients and outpatients with AF presenting to cardiologists in the two biggest Lithuanian university hospitals from November 2013 to May 2014. AF diagnosis was confirmed by a 12-lead ECG or 24-h Holter with an episode duration of >30s.
A total number of 575 patients were recruited, and complete data on clinical subtype were available for 515 patients (mean age of 70.7 years; 48.5% of women). Permanent AF was the most frequent type of AF (46.6%). Common comorbidities were hypertension (85.8%), heart failure (77.9%) and coronary artery disease (51.8%). Amiodarone was the most common antiarrhythmic agent used in 14.6% of the patients, while beta-blockers and digoxin were the most often used rate control drugs (59.6% and 10.7%, respectively). Oral anticoagulants were used by 53.3% of the patients; of them, 95.6% used vitamin K antagonists, while non-vitamin K antagonist were used by only 4.4%. The INR within a therapeutic range (2.0-3.0) was documented in 19.2% of the patients. Other antithrombotic drugs such as aspirin and clopidogrel were used in 13.7% and 2.0% of the patients, respectively; dual antiplatelet treatment was administered in 6.2% of the patients. Of the entire cohort, the mean CHADS-VASc score was 3.97±1.6 and the mean HAS-BLED score was 2.25±1.0.
Compliance with the treatment guidelines remains suboptimal and further patient education is needed.
本研究旨在调查立陶宛大学医院收治患者中房颤（AF）最常见的危险因素、合并症、与房颤相关的并发症以及抗凝剂和其他药物的使用情况。
这项横断面研究纳入了2013年11月至2014年5月在立陶宛两家最大的大学医院心内科就诊的连续住院和门诊房颤患者。房颤诊断通过12导联心电图或24小时动态心电图确认，发作持续时间>30秒。
共招募了575例患者，515例患者有完整的临床亚型数据（平均年龄70.7岁；48.5%为女性）。永久性房颤是最常见的房颤类型（46.6%）。常见合并症为高血压（85.8%）、心力衰竭（77.9%）和冠状动脉疾病（51.8%）。胺碘酮是14.6%患者中最常用的抗心律失常药物，而β受体阻滞剂和地高辛是最常用的心率控制药物（分别为59.6%和10.7%）。53.3%的患者使用口服抗凝剂；其中，95.6%使用维生素K拮抗剂，仅4.4%使用非维生素K拮抗剂。19.2%的患者国际标准化比值（INR）在治疗范围内（2.0 - 3.0）。其他抗血栓药物如阿司匹林和氯吡格雷分别在13.7%和2.0%的患者中使用；6.2%的患者接受双联抗血小板治疗。在整个队列中，平均CHADS - VASc评分为3.97±1.6，平均HAS - BLED评分为2.25±1.0。
对治疗指南的依从性仍不理想，需要进一步对患者进行教育。
