Suboptimal oral anticoagulation in patients with nonvalvular atrial fibrillation and history of cerebrovascular disease in Mexico. Results from CARMEN-AF Registry.

IF 1.4 4区医学 Q2 Medicine

Revista De Investigacion Clinica-Clinical and Translational Investigation Pub Date : 2025-05-01 Epub Date: 2025-07-02 DOI:10.1016/j.ric.2025.100003

Carlos Cantú-Brito, Manuel Alfonso Baños-González, Jesus Antonio González-Hermosillo, Milton Ernesto Guevara-Valdivia, Jorge Abel Vázquez-Acosta, José Luis Leiva-Pons, Alejandro Lechuga-Martin Del Campo, Humberto Rodríguez-Reyes, Janneth Manzano-Cabada, Manlio Fabio Márquez-Murillo, Manuel Odín de Los Ríos-Ibarra, Julio Alberto Aguilar-Linares, Gerardo Pozas-Garza, Eddie Alberto Favela-Pérez, Luis Molina-Fernández de Lara, Reynaldo Magaña Magaña, Rocío Camacho-Casillas, Cesar Vásquez-Serna, Norberto Matadamas-Hernández, Ulises Rojel-Martínez, Miguel Negrete-Rivera, Héctor Fernández-Saldaña, Marco Islava-Galvez, Lidia Betancourt-Hernández, Demetrio Kosturakis-García, Alberto Baños-Velasco, Miguel Beltrán-Gámez, Susano Lara-Vaca, José Luis Novelo-Del Valle, Luis Delgado-Leal, Luis Trujillo-Muñoz, Raúl Isaac-Márquez, Enrique Martínez-Flores, Nicolás Reyes-Reyes, Ramón Miguel Esturau-Santaló, José Fabián Hernández-Díaz, Juan Carlos Núñez-Fragoso, José Manuel Enciso Muñoz, María Isabel Sánchez-Ramírez

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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) increases the risk of stroke, especially in patients with previous cerebrovascular disease. This risk is significantly reduced with oral anticoagulants (OAC), with direct oral anticoagulants (DOACs) being the optimal treatment.

Objectives: To study the most used anticoagulant treatment in patients with nonvalvular AF (NVAF) with and without cerebrovascular disease in Mexico.

Methods: CARMEN-AF is a national, multicentric observational registry that includes 1423 patients with AF. Patients were recruited regardless of the anticoagulant therapy. Demographics, clinical variables, comorbidities and antithrombotic treatment were compared among patients with and without a history of cerebrovascular disease.

Results: Of the 238 patients with a previous cerebrovascular disease (average age 69±13 years; 114 women [48.5%]), 99% had a previous ischemic stroke. In this subgroup, the type of AF was permanent 43.4%, persistent 20%, and paroxysmal AF was 36.6%. Principal comorbidities were hypertension 77.9%, diabetes mellitus 29.8%, and heart failure 20%. Nearly 12.4% of patients with a history of ischemic cerebrovascular disease did not receive anticoagulant (AC) treatment. Among those who did, vitamin K antagonists (VKAs) were more commonly prescribed than DOACs (37.4% vs. 25.5%).

Conclusion: In Mexico, anticoagulation rates remain low among patients with NVAF and a history of cerebrovascular disease.

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墨西哥有脑血管病史的非瓣膜性心房颤动患者的次优口服抗凝CARMEN-AF Registry的结果。

背景：房颤（AF）增加卒中的风险，特别是既往有脑血管疾病的患者。口服抗凝剂（OAC）可显著降低这种风险，直接口服抗凝剂（DOACs）是最佳治疗方法。目的：研究墨西哥伴有和不伴有脑血管疾病的非瓣膜性房颤（NVAF）患者最常用的抗凝治疗方法。方法：CARMEN-AF是一项全国性、多中心的观察性登记，包括1423例房颤患者。无论抗凝治疗如何，患者都被招募。在有和没有脑血管病史的患者中比较人口统计学、临床变量、合并症和抗血栓治疗。结果：238例既往脑血管疾病患者（平均年龄69±13岁；114例女性[48.5%]）中，99%既往缺血性卒中。在这个亚组中，永久性房颤占43.4%，持续性房颤占20%，阵发性房颤占36.6%。主要合并症为高血压77.9%，糖尿病29.8%，心力衰竭20%。近12.4%有缺血性脑血管病史的患者未接受抗凝治疗。在这些患者中，维生素K拮抗剂（VKAs）比DOACs更常用（37.4%对25.5%）。结论：在墨西哥，有脑血管病史的非瓣膜性房颤患者的抗凝血率仍然很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista De Investigacion Clinica-Clinical and Translational Investigation 医学-医学：内科

CiteScore

3.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Revista de Investigación Clínica – Clinical and Translational Investigation (RIC-C&TI), publishes original clinical and biomedical research of interest to physicians in internal medicine, surgery, and any of their specialties. The Revista de Investigación Clínica – Clinical and Translational Investigation is the official journal of the National Institutes of Health of Mexico, which comprises a group of Institutes and High Specialty Hospitals belonging to the Ministery of Health. The journal is published both on-line and in printed version, appears bimonthly and publishes peer-reviewed original research articles as well as brief and in-depth reviews. All articles published are open access and can be immediately and permanently free for everyone to read and download. The journal accepts clinical and molecular research articles, short reports and reviews. Types of manuscripts: – Brief Communications – Research Letters – Original Articles – Brief Reviews – In-depth Reviews – Perspectives – Letters to the Editor