Chao Tze-Fan, Choi Eue-Keun, Guo Yutao, Shimizu Wataru, Tse Hung-Fat, Lip Gregory Y H
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Lancet Reg Health West Pac. 2025 Feb 15;56:101495. doi: 10.1016/j.lanwpc.2025.101495. eCollection 2025 Mar.
East Asian populations exhibit a high burden of atrial fibrillation (AF) and AF-related ischemic strokes. The countries/regions in East Asia have diversities regarding patient characteristics and varying patient care represented by different adherence rates to the ABC (Atrial Fibrillation Better Care) pathway. Two changes, "from non-anticoagulation to direct oral anticoagulants (DOACs)" and "from lower dosing to appropriate dosing DOACs", have been identified in East Asia and have been temporally linked to improved clinical outcomes in AF patients. Additional efforts are necessary to further reduce the stroke risk among AF patients, including increased communication with other specialists/societies, the initiation of prospective studies or clinical trials in Asia, and the implementation of evidence-based holistic or integrated care management based on the ABC pathway.
东亚人群房颤(AF)及与房颤相关的缺血性卒中负担较重。东亚地区的国家/地区在患者特征方面存在差异,不同国家/地区对ABC(房颤更佳治疗)路径的依从率也有所不同,这体现了不同的患者护理情况。在东亚地区已发现两项变化,即“从不抗凝治疗转为直接口服抗凝药(DOACs)”以及“从低剂量DOACs转为适当剂量DOACs”,并且这两项变化在时间上与房颤患者临床结局的改善相关。还需要做出更多努力,以进一步降低房颤患者的卒中风险,包括加强与其他专科/学会的沟通、在亚洲开展前瞻性研究或临床试验,以及基于ABC路径实施循证整体或综合护理管理。