Guelker Jan-Erik, Bufe Alexander, Klues Heinrich, Shin Dong-In, Blockhaus Christian, Gabriel Nils-Holger, Haverkamp Wilhelm, Kroeger Knut
Heartcentre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Germany; Institute for Heart and Circulation Research, University Cologne, Germany.
Heartcentre Niederrhein, Department of Cardiology, Helios Clinic Krefeld, Germany; Institute for Heart and Circulation Research, University Cologne, Germany; University of Witten/Herdecke, Germany.
Cardiovasc Revasc Med. 2019 May;20(5):399-402. doi: 10.1016/j.carrev.2018.07.019. Epub 2018 Jul 21.
The aim of the study was to compare trends in frequency of atrial fibrillation (AF) with the prescription rates of oral anticoagulants (OAC) and the incidence of embolic stroke (ES) from 2005 through 2014.
Annual numbers of hospitalized patients with AF and ES were extracted from the Federal Bureau of Statistics. Defined daily doses (DDD) of prescribed OAC among outpatients were extracted from the insurance drug information system.
The number of cases hospitalized with the diagnosis AF increased continuously by 78.3% (1.25 Million in 2005 to 2.19 Million in 2014, p < 0.001), likewise frequency of ES increased by 89.0% (from 46,068 to 87,050, p < 0.001) and the number of prescribed DDD of OAC almost doubled by 105.4% (from 271,328 to 557,281, p < 0.001). There is an almost linear correlation between occurrence of AF and ES (R = 0.9683). In contrast association between prescription rate of OAC and incidence of ES is not linear as there was a disproportional increase in OAC prescriptions beginning in the year 2010 that is not accompanied by a reduction of cases hospitalized with ES.
Our analysis of drug treatment rates for OAC in outpatients and hospitalization rates for ES revealed a disproportional increase in prescription of OAC beginning in the year 2010 that does not affect the number of cases hospitalized with ES.
本研究的目的是比较2005年至2014年期间心房颤动（AF）的发生频率、口服抗凝剂（OAC）的处方率以及栓塞性卒中（ES）的发病率趋势。
从联邦统计局提取每年因AF和ES住院的患者数量。从保险药品信息系统中提取门诊患者中OAC的规定日剂量（DDD）。
诊断为AF的住院病例数持续增加了78.3%（从2005年的125万例增加到2014年的219万例，p<0.001），同样ES的发生频率增加了89.0%（从46068例增加到87050例，p<0.001），OAC的规定DDD数量几乎翻了一番，增加了105.4%（从271328例增加到557281例，p<0.001）。AF和ES的发生之间几乎呈线性相关（R=0.9683）。相比之下，OAC处方率与ES发病率之间的关联不是线性的，因为从2010年开始OAC处方量不成比例地增加，而ES住院病例数并未减少。
我们对门诊患者OAC药物治疗率和ES住院率的分析显示，从2010年开始OAC处方量不成比例地增加，但这并未影响ES住院病例数。
