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Clinical characteristics and one year outcomes in Chinese atrial fibrillation patients with stable coronary artery disease： a population-based study

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Journal of Geriatric Cardiology 2016年第8期13卷 665-671页

作者： Ying BAI Jun ZHU Yan-Min YANG Yan LIANG Hui-Qiong TAN Juan WANG Bi HUANG Han ZHANG Xing-Hui SHAO State Key Laboratory of Cardiovascular Disease Emergency and Critical Care Center National Center for Cardiovascular Diseases Fuwai Hospital BeijingChina

Background Atrial fibrillation （AF） and coronary artery disease （CAD） often coexist, however, the clinical characteristics and the impact of stable CAD on the outcomes in Chinese patients with AF has not been well understood. Methods Consecutive AF patients in 20 hospitals in China from November 2008 to October 2011 were enrolled. The primary endpoints included 1-year all-cause mortality, stroke, non-central nervous system （non-CNS） embolism, and major bleeding. Results A total of 1947 AF patients were analyzed, of whom 40.5% had stable CAD. The mean chads2 scores in CAD patients were significantly higher than that of non-CAD patients （2.4 - 1.4 vs. 1.4 - 1.2, P 〈 0.001）. During follow-up period, warfarin use is low in both groups, with relatively higher proportion in non-CAD patients compared with CAD patients （22.3% vs. 10.7%, P 〈 0.001）. Compared with non-CAD patients, CAD patients had higher one-year all-cause mortality （16.8% vs. 12.9%, P = 0.017） and incidence of stroke （9.0% vs. 6.4%, P = 0.030）, while the non-CNS embolism and major bleeding rates were comparable between the two groups. After multivariate adjustment, stable CAD was independently associated with increased risk of 1-year all-cause mortality （HR = 1.35, 95% CI： 1.01-1 .80, P = 0.040）, but not associated with stroke （HR = 1.07, 95% CI： 0.72-1.58, P = 0.736）. Conclusions Stable CAD was prevalent in Chinese AF patients and was independently associated with increased risk of 1-year all-cause mortality. Chinese AF patients with stable CAD received inadequate antithrombotic therapy and this grim status of antithrombotic therapy needed to be improved urgently.

关键词： Antithrombotic therapy Atrial fibrillation chads2 score Stable coronary artery disease

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