Balaghi-Inalou Marzieh, Parsa Saeed Alipour, Gachkar Latif, Andalib Sasan
Cardiovascular Research Center, Department of Cardiology, Modarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
High Blood Press Cardiovasc Prev. 2018 Mar;25(1):61-64. doi: 10.1007/s40292-017-0237-9. Epub 2017 Oct 26.
To prevent stroke, anticoagulants should be administered after calculation of CHA2DS2-VASc and HAS-BLED scores in patients with Atrial Fibrillation (AF); nonetheless, these scores are sometimes neglected in clinical settings.
The present study was designed to assess agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores in Iranian AF patients in Moddares Hospital.
AF patients were diagnosed according to clinical history, clinical examination, and electrocardiogram. Data including the anticoagulant prescription according to clinicians were recorded. CHA2DS2-VASc and HAS-BLED scores were then calculated for each patient. Agreement of anticoagulant therapy according to clinicians and CHA2DS2-VASc and HAS-BLED scores was analyzed using Cohen's kappa coefficient.
97.5% of the patients (n = 117) were appropriately (according CHA2DS2-VASc and HAS-BLED scores) treated with anticoagulants by clinicians, notwithstanding a 2.5% of patients with inappropriate anticoagulant therapy (n = 3). The Cohen's kappa coefficient was 0.81 (P = 0.0).
The findings of the present study suggest an almost perfect agreement between anticoagulant therapy according to clinicians and that according to CHA2DS2-VASc and HAS-BLED scores in the studied population.
为预防中风，心房颤动（AF）患者应在计算CHA2DS2-VASc和HAS-BLED评分后使用抗凝剂；然而，在临床环境中，这些评分有时会被忽视。
本研究旨在评估德黑兰莫达雷斯医院伊朗AF患者中临床医生的抗凝治疗与CHA2DS2-VASc和HAS-BLED评分之间的一致性。
根据临床病史、临床检查和心电图诊断AF患者。记录包括临床医生开具的抗凝剂处方在内的数据。然后为每位患者计算CHA2DS2-VASc和HAS-BLED评分。使用科恩kappa系数分析临床医生的抗凝治疗与CHA2DS2-VASc和HAS-BLED评分之间的一致性。
97.5%的患者（n = 117）得到了临床医生的适当（根据CHA2DS2-VASc和HAS-BLED评分）抗凝治疗，尽管有2.5%的患者接受了不适当的抗凝治疗（n = 3）。科恩kappa系数为0.81（P = 0.0）。
本研究结果表明，在研究人群中，临床医生的抗凝治疗与根据CHA2DS2-VASc和HAS-BLED评分的抗凝治疗之间几乎完全一致。
