Department of Basic Medical Sciences, Faculty of Public Health, Medical University of Silesia, Katowice, Poland.
Department of Biostatistics, Faculty of Public Health, Medical University of Silesia, Katowice, Poland.
Neurol Neurochir Pol. 2017 Sep-Oct;51(5):382-387. doi: 10.1016/j.pjnns.2017.07.005. Epub 2017 Jul 11.
Atrial fibrillation (AF) is the most frequent clinically significant arrhythmia, especially common in the elderly. As it is known, AF is associated with increased risk of stroke. Little is known about pharmacological cardiovascular prevention in the elderly with AF in Poland.
The purpose of the study was to evaluate the frequency of pharmacological stroke prevention among the elderly with AF in Poland and its association with clinical characteristics and concomitant cardiovascular risk factors.
The analysis included elderly (≥65 years) participants of the PolSenior study performed in years 2008-2012.
The study group consisted of 4979 people (mean age: 79.3±8.7 years). Among them, there were 875 patients (18.7%) with documented history of AF. Pharmacological prevention with the use of vitamin K antagonists (VKA) was applied by 117 (13.4%) of the elderly with AF, including 15 (1.7%) on dual therapy. Additionally, 386 (45.3%) subjects with AF were using oral antiplatelet therapy (OAPs), mostly aspirin. Acenocoumarol was much more often used than warfarin. New oral anticoagulant drugs (NOACs) were not used at all. Only personal income was associated with the use of VKA. No significant correlation was found for the age, sex, place of residence and level of education.
The study was unique to determine the frequency of pharmacological stroke prevention among elderly people with AF in Poland. It occurred that oral anticoagulant drugs were applied too rarely in this group of patients. Educational programs should be developed among general practitioners concerning current recommendations for patients with AF.
心房颤动（AF）是最常见的具有临床意义的心律失常，尤其在老年人中常见。众所周知，AF 与中风风险增加有关。在波兰，关于 AF 老年患者的药理学心血管预防措施知之甚少。
本研究旨在评估波兰 AF 老年患者进行药理学卒中预防的频率及其与临床特征和并存心血管危险因素的关系。
该分析纳入了 2008-2012 年进行的 PolSenior 研究中的老年（≥65 岁）参与者。
研究组由 4979 人（平均年龄：79.3±8.7 岁）组成。其中，有 875 名（18.7%）患者有记录的 AF 病史。117 名（13.4%）AF 老年患者应用维生素 K 拮抗剂（VKA）进行药理学预防，其中 15 名（1.7%）接受双重治疗。此外，386 名（45.3%）AF 患者使用口服抗血小板治疗（OAPs），主要是阿司匹林。醋硝香豆素的使用比华法林更为常见。新型口服抗凝药物（NOACs）根本未被使用。只有个人收入与 VKA 的使用相关。年龄、性别、居住地和教育水平与 VKA 的使用均无显著相关性。
本研究是唯一一项确定波兰 AF 老年患者进行药理学卒中预防频率的研究。结果表明，该组患者中口服抗凝药物的应用非常少。应该针对普通医生制定关于 AF 患者的当前推荐的教育计划。
