随着抗凝药物使用率的提高，房颤患者的缺血性卒中发生率下降：一项瑞典队列研究。
Ischemic stroke rates decline in patients with atrial fibrillation as anticoagulants uptake improves: A Swedish cohort study.
机构信息
Department of Cardiology, Skåne University Hospital, S-2050 Malmö, Sweden.
Department of Cardiology, Skåne University Hospital, S-221 85 Lund, Sweden.
出版信息
Thromb Res. 2017 Oct;158:44-48. doi: 10.1016/j.thromres.2017.08.004. Epub 2017 Aug 11.
INTRODUCTION
The impact of the increased anticoagulants uptake on incidence rate of ischemic stroke is largely unknown. We assessed time trends in rates of ischemic stroke in patients with incident atrial fibrillation (AF) diagnosed between 2011 and 2013.
MATERIALS AND METHODS
Population-based retrospective registry study of all 11,500 adults diagnosed with incident non-valvular atrial fibrillation in 2011-2013 in primary and secondary care and receiving oral anticoagulants (n=4847), aspirin (n=2850) or no treatment (n=3766) in Skåne County, Sweden. The primary outcome was the rate of ischemic stroke within 365days after AF diagnosis.
RESULTS AND CONCLUSION
Cumulative incidence of ischemic stroke decreased from 2.87% (95% confidence interval (CI) 2.37-3.45%) to 1.93% (95% CI 1.54-2.41%) while the uptake of oral anticoagulants increased from 36.6% to 48.4% between 2011 and 2013 (regression coefficient -0.08; 95% CI, -0.09 to -0.07, p<0.001). The increased uptake of oral anticoagulants in the community is associated with decreased incidence of ischemic stroke in AF patients.
简介
抗凝药物使用率的增加对缺血性卒中发生率的影响尚不清楚。我们评估了 2011 年至 2013 年期间诊断为新发心房颤动（AF）的患者中缺血性卒中发生率的时间趋势。
材料和方法
这是一项基于人群的回顾性登记研究，纳入了瑞典斯科讷省初级和二级保健机构中 2011-2013 年间诊断为新发非瓣膜性心房颤动的所有 11500 例成年人（n=4847），他们接受了口服抗凝剂（n=4847）、阿司匹林（n=2850）或未治疗（n=3766）。主要结局是 AF 诊断后 365 天内缺血性卒中的发生率。
结果和结论
缺血性卒中的累积发生率从 2.87%（95%置信区间（CI）2.37-3.45%）降至 1.93%（95% CI 1.54-2.41%），而口服抗凝药物的使用率从 2011 年的 36.6%增加到 2013 年的 48.4%（回归系数-0.08；95%CI，-0.09 至-0.07，p<0.001）。社区中口服抗凝药物使用率的增加与 AF 患者缺血性卒中发生率的降低相关。
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