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Effect of complete revascularization in acute coronary syndrome after 75 years old:insights from the BleeMACS registry

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Journal of Geriatric Cardiology 2023年第10期20卷 728-736页

作者： Ge WANG Xiu-Huan CHEN Si-Yi LI Ze-Kun ZHANG Wei GONG Yan YAN Shao-Ping NIE JoséP.Henriques on behalf.of.the BleeMACS registry investigators Center for Coronary Artery Disease Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Cardiology Amsterdam University Medical CenterAmsterdamthe Netherlands 不详

BACKGROUND The prognostic benefit of complete revascularization in elderly patients(aged over 75 years)with multi-vessel disease and acute coronary syndrome(ACS)is currently *** study aimed to determine the long-term prognostic impact of complete revascularization in this *** We conducted this study using data obtained from the BleeMACS(Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome)registry,which was carried out from 2003 to *** objective was to categorize older patients diagnosed with ACS into two groups:those who underwent complete revascularization and those who did *** score matching and the Kaplan-Meier analysis were employed to examine differences in one-year clinical *** primary endpoint was major adverse cardiovascular event(MACE),which encompassed a combination of all-cause mortality and myocardial *** Out of 1263 patients evaluated,445 patients(35.2%)received complete *** who underwent complete revascularization had a higher prevalence of hypertension and prior percutaneous coronary intervention compared to those who did *** the one-year follow-up period,complete revascularization was associated with a significantly decreased risk of MACE[13.7%vs.20.5%,hazard ratio(HR)=0.63,95%CI:0.45–0.88,P=0.007]and a lower risk of myocardial infarction(5.9%vs.9.9%,HR=0.55,95%CI:0.33–0.92,P=0.02).However,it was not linked to a lower risk of all-cause death(9.5%vs.13.5%,HR=0.68,95%CI:0.45–1.02,P=0.06).Similar results were observed in the subgroup *** Long-term clinical improvements were observed in ACS patients aged over 75 years with multi-vessel disease who achieved complete ***,adhering to guidelines for complete revascularization should be recommended for elderly patients.

关键词： coronary revascularization acute

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Association between coexisting intracranial artery and extracranial carotid artery atherosclerotic diseases and ipsilateral cerebral infarction: a Chinese Atherosclerosis Risk Evaluation (CARE- II) study

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Stroke & Vascular Neurology 2021年第4期6卷 595-602页

作者： Chunxiu Jiang Jing Zhang Jianbin Zhu Xianlong Wang Zhibo Wen Xihai Zhao Chun Yuan On behalf of CARE-II investigators Department of Radiology Zhujiang HospitalSouthern Medical UniversityGuangzhouChina Department of Radiology Foshan Women and Children Hospital Affiliated to Southern Medical UniversityFoshanChina Center for Biomedical Imaging Research Department of Biomedical EngineeringTsinghua UniversityBeijingChina Department of Radiology University of WashingtonSeattleWashingtonUSA 不详

Background To evaluate the association between coexisting intracranial and extracranial carotid artery atherosclerotic diseases and ipsilateral acute cerebral infarct(ACI)in symptomatic patients by using magnetic resonance(mr)vessel wall *** Symptomatic patients were recruited from a cross-sectional,multicentre study of Chinese Atherosclerosis Risk Evaluation(CARE-II).All patients underwent mr imaging for extracranial carotid arterial wall,intracranial artery and *** intracranial stenosis≥50%and extracranial carotid artery mean wall thickness(MWT)≥1 mm and plaque compositions at the same side were evaluated and the ipsilateral ACI was *** association between coexisting atherosclerotic diseases and ACI was evaluated using logistic *** 351 patients were *** with ipsilateral ACI had significantly greater prevalence of coexisting intracranial stenosis≥50%and carotid MWT≥1 mm(20.5%vs 4.9%,p<0.001),calcification(15.1%vs 4.4%,p=0.001)and lipid-rich necrotic core(LRNC)(19.2%vs 7.8%,p=0.002)compared with those *** intracranial artery stenosis≥50%and carotid MWT≥1 mm(OR 5.043,95%CI 2.378 to 10.694;p<0.001),calcification(OR 3.864,95%CI 1.723 to 8.664;p=0.001)and LRNC(OR 2.803,95%CI 1.455 to 5.401;p=0.002)were significantly associated with ipsilateral *** adjusting for confounding factors,the aforementioned associations remained statistically significant(intracranial stenosis≥50%coexisting with carotid MWT≥1 mm:OR 4.313,95%CI 1.937 to 9.601,p<0.001;calcification:OR 3.606,95%CI 1.513 to 8.593,p=0.004;LRNC:OR 2.358,95%CI 1.166 to 4.769,p=0.017).Conclusions Coexistence of intracranial artery severe stenosis and extracranial carotid artery large burden and intraplaque components of calcification and LRNC are independently associated with ipsilateral *** registration number https://***/.Unique identifier:NCT02017756.

关键词： intracranial carotid cerebral

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急性高血糖对ST段抬高性心肌梗死院内预后的影响

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中华内科杂志 2007年第10期46卷 820-823页

作者： registry of acute treatment in myocardial infarction investigators. 心肌梗死紧急医学救治系统研究协作组

目的探讨急性高血糖对 ST 段抬高性心肌梗死(STEMI)患者院内预后的影响。方法连续入选356例北京地区17家三级和二级医院所有在24h 内入院且符合 STEMI 诊断标准的患者。以人院血糖水平>11mmol/L 判定为高血糖,分为高血糖组和血糖正常组... 详细信息

目的探讨急性高血糖对 ST 段抬高性心肌梗死(STEMI)患者院内预后的影响。方法连续入选356例北京地区17家三级和二级医院所有在24h 内入院且符合 STEMI 诊断标准的患者。以人院血糖水平>11mmol/L 判定为高血糖,分为高血糖组和血糖正常组,观察两组患者院内死亡和心血管病事件的发生情况。院内心血管事件定义为院内再发心肌梗死、新发生的心力衰竭、严重心律失常及卒中。结果 356例 STEMI 患者中,存在急性高血糖患者共81例(22.8%)。其院内病死率较无急性高血糖患者显著增加(13.6%比5.1%,P=0.009),院内心血管事件发生率亦显著增多(32.1%比20.4%,P=0.027)。logistic 回归分析示,入院急性高血糖(OR 1.615,95%CI 1.116～2.338,P=0.011)为 STEMI 患者院内不良预后的独立危险因素。结论 STEMI 急性高血糖患者院内死亡及发生院内心血管事件的危险性显著高于入院血糖正常者。入院高血糖为 STEMI 患者院内不良预后的独立危险因素。

关键词：高血糖症心肌梗塞预后

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Endovascular treatment in anterior circulation stroke beyond 6.5 hours after onset or time last seen well:results from the mr clean registry

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Stroke & Vascular Neurology 2021年第4期6卷 572-580,I0037-I0048页

作者： Luuk Dekker Esmee Venema F Anne V Pirson Charles B L M Majoie Bart J Emmer Ivo G H Jansen Maxim J H L Mulder Robin Lemmens Robert-Jan B Goldhoorn Marieke J H Wermer Jelis Boiten Geert J LycklamaàNijeholt Yvo B W E M Roos Adriaan C G M van Es Hester F Lingsma Diederik W J Dippel Wim H van Zwam Robert J van Oostenbrugge Ido R van den Wijngaard on behalf.of.the mr clean registry investigators Neurology Leiden University Medical CentreLeidenThe Netherlands Neurology Erasmus MCRotterdamThe Netherlands Public Health Erasmus MCRotterdamThe Netherlands Neurology Maastricht University Medical Centre+MaastrichtThe Netherlands Radiology and Nuclear Medicine Amsterdam University Medical CentreLocation AMCAmsterdamThe Netherlands Neurology University Hospitals LeuvenLeuvenBelgium Neurosciences Experimental Neurology and Leuven Brain InstituteUniversity of LeuvenLeuvenBelgium VIB Center for Brain&Disease ResearchLaboratory of NeurobiologyLeuvenBelgium Neurology Haaglanden Medical CentreDen HaagThe Netherlands Radiology Haaglanden Medical CentreDen HaagThe Netherlands Neurology Amsterdam University Medical CentreLocation AMCAmsterdamThe Netherlands Radiology Leiden University Medical CentreLeidenThe Netherlands Radiology Maastricht University Medical Centre+MaastrichtThe Netherlands

Background Randomised controlled trials with perfusion selection have shown benefit of endovascular treatment(EVT)for ischaemic stroke between 6 and 24 hours after symptom onset or time last seen ***,outcomes after EVT in these late window patients without perfusion imaging are largely *** assessed their characteristics and outcomes in routine clinical *** The Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands registry,a prospective,multicentre study in the Netherlands,included patients with an anterior circulation occlusion who underwent EVT between 2014 and *** perfusion was no standard imaging *** used adjusted ordinal logistic regression analysis to compare patients treated within versus beyond 6.5 hours after propensity score matching on age,prestroke modified Rankin Scale(mrS),National Institutes of Health Stroke Scale,Alberta Stroke Programme Early CT Score(ASPECTS),collateral status,location of occlusion and treatment with intravenous *** included 3-month mrS score,functional independence(defined as mrS 0-2),and *** Of 3264 patients who underwent EVT,106(3.2%)were treated beyond 6.5 hours(median 8.5,IQR 6.9-10.6),of whom 93(87.7%)had unknown time of stroke *** perfusion was not performed in 87/106(80.2%)late window *** window patients were younger(mean 67 vs 70 years,pmrS 1.04,95%CI 0.56 to 1.93).Conclusions Without the use of CT perfusion selection criteria,EVT in the 6.5-24-hour time window was not associated with poorer outcome in selected patients with favourable clinical and CT/C

关键词： treatment beyond registry

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Mild haemoglobin drop and clinical outcomes in acute coronary syndrome patients:finding from the BleeMACS registry

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Journal of Geriatric Cardiology 2022年第12期19卷 981-989,1016页

作者： Ze-Kun ZHANG Yan YAN Si-Yi LI Sergio Raposeiras-Roubín Emad Abu-Assi JoséPHenriques Fabrizio D’Ascenzo Jorge Saucedo Wei GONG Shao-Ping NIE on behalf.of.the BleeMACS registry investigators Center for Coronary Artery Disease Division of CardiologyBeijing Anzhen HospitalCapital Medical UniversityBeijingChina National Clinical Research Center for Cardiovascular Diseases BeijingChina Beijing Institute of Heart Lungand Blood Vessel DiseasesBeijingChina Department of Cardiology Álvaro Cunqueiro University HospitalVigoSpain Department of Cardiology Amsterdam University Medical CenterAmsterdamthe Netherlands Division of Cardiology Department of Medical ScienceUniversity of TurinTurinItaly Division of Cardiovascular Medicine Medical College of WisconsinWisconsinUSA 不详

BACKGROUND Haemoglobin drop is common in acute coronary syndrome(ACS)patients and correlates with poor ***,the association between mild haemoglobin drop and adverse clinical outcome remains insufficiently *** study aimed to examine the association between in-hospital haemoglobin drop and risk for adverse clinical outcomes in ACS patients,especially those with mild *** Included patients from the BleeMACS(Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome)registry were categorized into three groups by the presence and amount of in-hospital haemoglobin drop(non-drop,mild drop and severe drop).The cut-off point between mild drop and severe drop is≥3 g/*** Cox regression was used to assess the association between haemoglobin drop and major adverse cardiac endpoints(MACE).Patients taking potent P2Y_(12) inhibitors were selected for the additional *** score matching was used to avoid selective bias in the additional *** Of 6911 patients,4949 patients(71.6%)experienced in-hospital haemoglobin *** with non-drop group,patients with haemoglobin drop had higher risk of MACE[adjusted hazard ratio(HR)=1.36,95%CI:1.03–1.80 for mild drop group;adjusted HR=1.70,95%CI:1.07–2.68 for severe drop group].Patients in mild drop group were less likely to receive potent P2Y_(12) inhibitors at discharge(mild drop group *** drop group ***-drop group:10.9%vs.10.7%vs.23.8%).After propensity score matching adjustment among patients with potent P2Y_(12) inhibitors,patients in mild drop group were not associated with an increased risk of MACE than those in non-drop group(adjusted HR=1.52,95%CI:0.49–4.72).CONCLUSIONS In-hospital haemoglobin drop was common in ACS patients and associated with a higher risk for adverse *** prescription for potent P2Y_(12) inhibitors may be responsible for poor prognoses among patients with mild haemoglobin dro

关键词： patients clinical coronary

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The effect of fasting plasma glucose on in-hospital mortality after acute myocardial infarction in patients with and without diabetes:findings from a prospective,nationwide,and multicenter registry

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Journal of Geriatric Cardiology 2024年第5期21卷 523-533页

作者： Rui FU Ying-Xuan ZHU Kong-Yong CUI Jin-Gang YANG Hai-Yan XU Dong YIN Wei-Hua SONG Hong-Jian WANG Cheng-Gang ZHU Lei FENG Wei WU Kai-HongCHEN Yan-Yan ZHAO Ye LU Ke-Fei DOU Yue-Jin YANG on behalf.of.the CAMI registry investigators Cardiometabolic Medicine Center Fuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Medical Research&Biometrics Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Coronary Heart Disease Center Fuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Guangzhou Traditional Chinese Medical College First Affiliated HospitalGuangdong ProvinceChina Department of Cardiology Longyan Hospital First HospitalFujian ProvinceChina 不详

OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism *** We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were *** were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,*** primary endpoint was in-hospital *** Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,*** with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not ***-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic *** FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic *** This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without *** might be useful to stratify patients with AMI.

关键词： patients fasting infarction

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中国内地2006至2007年经皮冠状动脉介入治疗注册登记分析

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中华心血管病杂志 2009年第1期37卷 26-29页

作者：吕树铮宋现涛陈韵岱代表中国经皮冠状动脉介入治疗登记调查研究协作组

目的分析中圈内地各省、自治区和直辖市日前经皮冠状动脉介入治疗（PCI）开展情况。方法通过发放注册髓记表格的方法，收集2006至2007年中圜内地各省、自治区和直辖市能独立开展PCI医院的相关信息。结果（1）2007年中国内地30个省、自... 详细信息

目的分析中圈内地各省、自治区和直辖市日前经皮冠状动脉介入治疗（PCI）开展情况。方法通过发放注册髓记表格的方法，收集2006至2007年中圜内地各省、自治区和直辖市能独立开展PCI医院的相关信息。结果（1）2007年中国内地30个省、自治区和直辖市870所医院共完成PCI144673例；2006年1078所医院共完成PCI112580例。与2006年比较，2007年PCI数量增长幅度较大的省市有：福建省（327．3％）、安徽省（115．1％）、广东省（86．9％）。（2）2007年10个省市的PCI数量占总量的2／3：北京市占15．4％、广东省占8．0％、辽宁省占6．9％、山东省占6．9％、上海市占6．1％、河南省占5．8％、浙江省占4．7％、汀苏省占4．4％、陕西省占4．4％、河北省占4．2％。（3）2007年中国内地年完成PCI数量≥100例的医院有299所，占医院总数的34．4％。2006年中国内地年完成PCI数量≥100例的医院有290所，占医院总数的29．6％。2006年1078所医院中，年PCI例数〈50例的医院共有507所，占医院总数的47．0％，其完成的PCI共12086例，占总量的10．7％。（4）2006年672所医院完成的86974例PCI中，共置人支架135658枚，其小药物洗脱支架比例为97．8％，平均每例患者置入1．56枚支架。结论中国内地2006和2007年的PCI完成数量每年以超过10％的速度递增。年PCI例数〈50例医院的比例接近50％。平均每例患者置入1．56枚支架，其中97．8％为药物洗脱支架。

关键词：冠状动脉疾病血管成形术经腔经皮冠状动脉中国

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Effectiveness of intravenous r- tPA versus UK for acute ischaemic stroke: a nationwide prospective Chinese registry study

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Stroke & Vascular Neurology 2021年第4期6卷 603-609,I0060-I0066页

作者： Xinhong Wang Xiaoqiu Li Yuming Xu Runhui Li Qingcheng Yang Yong Zhao Fengyun Wang Baoying Sheng Runqing Wang Shaoyuan Chen Lihua Wang Liying Shen Xiaowen Hou Yu Cui Duolao Wang Bin Peng Craig S Anderson Huisheng Chen On behalf of INTRECIS investigators Neurology General Hospital of Northern Theatre CommandShenyangLiaoningChina Neurology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Neurology Central Hospital Affiliated to Shenyang Medical CollegeShenyangChina Neurology The People’s Hospital of Anyang CityAnyangChina Neurology Haicheng Hospital of Traditional Chinese MedicineHaichengChina Neurology Liaocheng People's HospitalLiaochengShandongChina Neurology The First Affiliated Hospital of Jiamusi UniversityJiamusiChina Neurology Zhengzhou Central HospitalZhengzhouChina Neurology The 32183 Military Hospital of PLABaichengChina Neurology The Second Affiliated Hospital of Harbin Medical UniversityHarbinChina Neurology Tieling County Central HospitalTielingChina Clinical Sciences Liverpool School of Tropical MedicineLiverpoolUK Neurology Peking Union Medical College HospitalBeijingChina The George Institute for Global Health SydneyNew South WalesAustralia 不详

Background Intravenous recombinant tissue plasminogen activator(r-tPA)and urokinase(UK)are both recommended for the treatment of acute ischaemic stroke(AIS)in China,but with few comparative outcome data being *** aimed to compare the outcomes of these two thrombolytic agents for the treatment of patients within 4.5 hours of onset of AIS in routine clinical practice in *** A pre-planned,prospective,nationwide,multicentre,real-world registry of consecutive patients with AIS(age≥18 years)who received r-tPA or UK within 4.5 hours of symptom onset according to local decision-making and guideline recommendations during *** primary effectiveness outcome was the proportion of patients with an excellent functional outcome(defined by modified Rankin scale scores 0 to 1)at 90 *** key safety endpoint was symptomatic intracranial haemorrhage according to standard *** logistic regression was used for comparative analysis,with adjustment according to propensity scores to ensure balance in baseline *** Overall,4130 patients with AIS were registered but 320 had incomplete or missing data,leaving 3810 with available data for analysis of whom 2666 received r-tPA(median dose 0.88(IQR 0.78-0.90)mg/kg)and 1144 received UK(1.71(1.43-2.00)×104 international unit per kilogram).There were several significant intergroup differences in patient characteristics:r-tPA patients were more educated,had less history of stroke,lower systolic blood pressure,greater neurological impairment and shorter treatment times from symptom onset than UK ***,in adjusted analysis,the frequency of excellent outcome(OR 1.18,95%CI 1.00 to 1.40,p=0.052)and symptomatic intracranial haemorrhage(OR 0.70,95%CI 0.33 to 1.47,p=0.344)were similar between *** UK may be as effective and carry a similar safety profile as r-tPA in treating mild to moderate AIS within guidelines in *** http://***

关键词： prospective routine nationwide

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Triglyceride glucose index predicts in-hospital mortality in patients with ST-segment elevation myocardial infarction who underwent primary angiography

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Journal of Geriatric Cardiology 2023年第3期20卷 185-194页

作者： Rui FU Yan-Yan ZHAO Kong-Yong CUI Jin-Gang YANG Hai-Yan XU Dong YIN Wei-Hua SONG Hong-Jian WANG Cheng-Gang ZHU Lei FENG Zhi-Fang WANG Qing-Sheng WANG Ye LU Ke-Fei DOU Yue-Jin YANG the CAMI registry investigators Cardiometabolic Medicine Center Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Medical Research&Biometrics Center Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Coronary Heart Disease Center Department of CardiologyFuwai HospitalNational Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseNational Clinical Research Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of Cardiology Xinxiang Central Hospitalthe Fourth Clinical College of Xinxiang Medical UniversityHenan ProvinceChina Department of Cardiology Qinhuangdao First HospitalHebei ProvinceChina

OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective,nationwide,multicenter CAMI *** index was calculated with the formula:Ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].Patients were divided into three groups according to the tertiles of TyG *** primary endpoint was in-hospital *** Overall,46 patients died during hospitalization,in-hospital mortality was 1.5%,2.2%,2.6%for tertile 1,tertile 2,and tertile 3,***,TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression ***,after adjusting for age and sex,TyG index was significantly associated with higher mortality when regarded as a continuous variable(adjusted OR=1.75,95%CI:1.16-2.63)or categorical variable(tertile 3 *** 1:adjus-ted OR=2.50,95%CI:1.14-5.49).Furthermore,TyG index,either as a continuous variable(adjusted OR=2.54,95%CI:1.42-4.54)or categorical variable(tertile 3 *** 1:adjusted OR=3.57,95%CI:1.24-10.29),was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression *** subgroup analysis,the pro-gnostic effect of high TyG index was more significant in patients with body mass index<18.5 kg/m2(P interaction=0.006).CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography,especially in underweight patients.

关键词： patients mortality angiography

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非瓣膜病心房颤动患者全球抗凝注册研究中国亚组基线数据分析

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中华心血管病杂志 2014年第10期42卷 846-850页

作者：孙艺红胡大一北京大学人民医院心内科 100044

目的通过对全球注册研究GARFIELD研究中国患者基线数据的分析,揭示目前中国非瓣膜病心房颤动（房颤）患者抗栓治疗的现状.方法 GARFIELD研究是一项全球性、前瞻性伴部分回顾性多中心观察性注册研究,包括前瞻性队列和回顾性队列2个部分... 详细信息

目的通过对全球注册研究GARFIELD研究中国患者基线数据的分析,揭示目前中国非瓣膜病心房颤动（房颤）患者抗栓治疗的现状.方法 GARFIELD研究是一项全球性、前瞻性伴部分回顾性多中心观察性注册研究,包括前瞻性队列和回顾性队列2个部分.在中国按地域分布简单随机抽样法选取29家医院,均为三甲医院.收集患者的一般特征、临床特征及诊断时的抗栓治疗,并计算CHADS2评分和CHA2 DS2-VASc评分,如上述评分≥2为卒中高危.结果 2009年12月至2011年10月,共805例非瓣膜病房颤患者进入分析,平均年龄为（66.6 ±11.4）岁,女性317例（39.4％）,年龄≥75岁的患者216例（26.8％）.合并卒中和（或）短暂性脑供血不足（TIA） 116例（14.4％）,合并冠状动脉疾病患者261例（32.4％）.患者CHADS2评分平均（1.7±1.1）分,CHA2 DS2-VASc评分平均（2.9±1.7）分.CHADS2评分≥2分的患者有391例（48.5％）,CHA2DS2-VASc≥2分的患者有630例（78.3％）.未用任何抗栓治疗的患者159例（19.8％）;415例（51.6％）患者接受抗血小板治疗;接受抗凝治疗的患者231例（28.7％）,其中华法林179例（22.2％）,新型口服抗凝药物52例（6.5％）.在卒中高风险患者抗凝治疗率低,其中68.3％（267/391）CHADS2评分≥2分和71.7％（452/630） CHA2DS2-VASc评分≥2分的患者未接受抗凝治疗.随着CHADS2和CHA2 DS2-VASc评分增加,服用新型口服抗凝治疗的患者比例升高,CHADS2-VASc评分≥6分的患者服用新型口服抗凝药物比例与华法林相同,均为14.9％（7/47）.结论中国非瓣膜病房颤抗凝治疗的现状虽有改进仍不容乐观,抗栓治疗未按危险分层标准进行,卒中高危患者抗凝治疗率低.

关键词：心房颤动抗凝药卒中

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