Wakabayashi Yasushi, Sugawara Yoshitaka, Fujita Kanna, Hayashi Takekuni, Ikeda Nahoko, Umemoto Tomio, Wada Hiroshi, Sakakura Kenichi, Funayama Hiroshi, Mitsuhashi Takeshi, Fujita Hideo, Momomura Shin-Ichi
Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya-ku, Saitama, Saitama, 330-8503, Japan.
Heart Vessels. 2017 Nov;32(11):1382-1389. doi: 10.1007/s00380-017-1009-0. Epub 2017 Jun 20.
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and carries an increased risk of cardiogenic embolism. Oral anticoagulants (OACs) including warfarin and/or non-vitamin K antagonists can prevent the majority of these events. The Saitama AF Registry was a community-based survey of patients with AF in Saitama City, which represents an urban community in Japan. A total of 75 institutions participated in the registry and attempted to enroll consecutive patients with AF from September 2014 to August 2015. The aim of the present study was to examine the clinical characteristics of patients with AF using data of the Saitama AF Registry. In addition, we investigated the difference in clinical characteristics of the patients between small-sized hospitals and large-sized hospitals. A total of 3591 patients were enrolled; 57.7% of all patients were enrolled from small-sized hospitals, whereas 42.3% were from large-sized hospitals. The patients from small-sized hospitals had higher CHADS score than those from large-sized hospitals. Approximately, 80% of all patients were treated with OACs, and the prescription rate was higher in patients with CHADS score ≥ 2 from both small-sized hospitals and large-sized hospitals. In conclusion, the present study demonstrated an appropriate use of OACs for high-risk patients with CHADS score ≥2 in Saitama City regardless of hospital size.
心房颤动（AF）是最常见的心律失常之一，且心源性栓塞风险增加。包括华法林和/或非维生素K拮抗剂在内的口服抗凝剂（OACs）可预防大多数此类事件。埼玉房颤登记处是一项针对日本埼玉市房颤患者的社区调查，该市代表一个城市社区。共有75家机构参与了该登记处的工作，并试图在2014年9月至2015年8月期间纳入连续的房颤患者。本研究的目的是利用埼玉房颤登记处的数据研究房颤患者的临床特征。此外，我们调查了小型医院和大型医院患者临床特征的差异。共纳入3591例患者；所有患者中57.7%来自小型医院，42.3%来自大型医院。来自小型医院的患者CHADS评分高于来自大型医院的患者。大约80%的所有患者接受了OACs治疗，小型医院和大型医院中CHADS评分≥2的患者处方率更高。总之，本研究表明，在埼玉市，无论医院规模大小，CHADS评分≥2的高危患者使用OACs是合适的。
