心房颤动和血栓栓塞事件低风险患者:抗凝治疗处方率的回顾性分析

Q3 Medicine

Russian Journal of Cardiology Pub Date : 2023-09-23 DOI:10.15829/1560-4071-2023-5522

M. A. Druzhilov, T. Yu. Kuznetsova

{"title":"心房颤动和血栓栓塞事件低风险患者:抗凝治疗处方率的回顾性分析","authors":"M. A. Druzhilov, T. Yu. Kuznetsova","doi":"10.15829/1560-4071-2023-5522","DOIUrl":null,"url":null,"abstract":"Aim. To conduct a retrospective analysis of the prevalence of main risk factors for thromboembolic events (TEEs) and the prescription rate of anticoagulant therapy (ACT) in patients with atrial fibrillation (AF) and a low CHA2DS2-VASc score in certain Russian regions using artificial intelligence technologies. Material and methods . The information was obtained from the Webiomed predictive analytics platform. The sample included 87601 patients with AF aged 18-74 years (men, 49,5%, mean age, 59,3±12,3 years, mean CHA 2 DS 2 -VASc score, 2,3±1,5) who received care in medical organizations in 6 constituent entities of the Russian Federation in the period from 2016 to 2019. CHA 2 DS 2 VASc score of 1 and 2 in a man and a woman, respectively, was regarded as a moderate risk, while score of 0 and 1, respectively, as a low risk of TEEs. Results. There were 22337 (25,5%) patients with AF at moderate risk and 18366 (21,0%) patients at low risk of TEEs. With a moderate risk of TEEs, CHA 2 DS 2 -VASc score of 1 in 70,4% of cases was determined by hypertension, while in 15,7% — by age 65-74 years, in 9,0% — by heart failure, in 2,9% — by myocardial infarction and/or peripheral arterial disease, in 2,0% — by type 2 diabetes. In patients with AF and a moderate risk of TEEs, ACT was prescribed in 4927 (22,1%) patients, while with a low risk of TEEs — in 1833 (10,0%). Among patients with AF and a high risk of TEEs (n=46898, 53,5%), 1216 (24,6%) patients with ischemic stroke (IS) did not initially have a high CHA 2 DS 2 -VASc risk. Conclusion. In clinical practice, among patients with AF aged 18-74 years, there are quite often individuals with CHA 2 DS 2 -VASc score of 1 not associated with sex. These patients need an individualized approach in ACT, which is the basis for prospective studies in order to optimize the assessment of cardioembolic IS risk, as well as to analyze the efficacy and safety of long-term ACT.","PeriodicalId":21389,"journal":{"name":"Russian Journal of Cardiology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patients with atrial fibrillation and a low risk of thromboembolic events: prescription rate of anticoagulant therapy according to a retrospective analysis\",\"authors\":\"M. A. Druzhilov, T. Yu. Kuznetsova\",\"doi\":\"10.15829/1560-4071-2023-5522\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim. To conduct a retrospective analysis of the prevalence of main risk factors for thromboembolic events (TEEs) and the prescription rate of anticoagulant therapy (ACT) in patients with atrial fibrillation (AF) and a low CHA2DS2-VASc score in certain Russian regions using artificial intelligence technologies. Material and methods . The information was obtained from the Webiomed predictive analytics platform. The sample included 87601 patients with AF aged 18-74 years (men, 49,5%, mean age, 59,3±12,3 years, mean CHA 2 DS 2 -VASc score, 2,3±1,5) who received care in medical organizations in 6 constituent entities of the Russian Federation in the period from 2016 to 2019. CHA 2 DS 2 VASc score of 1 and 2 in a man and a woman, respectively, was regarded as a moderate risk, while score of 0 and 1, respectively, as a low risk of TEEs. Results. There were 22337 (25,5%) patients with AF at moderate risk and 18366 (21,0%) patients at low risk of TEEs. With a moderate risk of TEEs, CHA 2 DS 2 -VASc score of 1 in 70,4% of cases was determined by hypertension, while in 15,7% — by age 65-74 years, in 9,0% — by heart failure, in 2,9% — by myocardial infarction and/or peripheral arterial disease, in 2,0% — by type 2 diabetes. In patients with AF and a moderate risk of TEEs, ACT was prescribed in 4927 (22,1%) patients, while with a low risk of TEEs — in 1833 (10,0%). Among patients with AF and a high risk of TEEs (n=46898, 53,5%), 1216 (24,6%) patients with ischemic stroke (IS) did not initially have a high CHA 2 DS 2 -VASc risk. Conclusion. In clinical practice, among patients with AF aged 18-74 years, there are quite often individuals with CHA 2 DS 2 -VASc score of 1 not associated with sex. These patients need an individualized approach in ACT, which is the basis for prospective studies in order to optimize the assessment of cardioembolic IS risk, as well as to analyze the efficacy and safety of long-term ACT.\",\"PeriodicalId\":21389,\"journal\":{\"name\":\"Russian Journal of Cardiology\",\"volume\":\"36 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Russian Journal of Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15829/1560-4071-2023-5522\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Russian Journal of Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15829/1560-4071-2023-5522","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

的目标。采用人工智能技术回顾性分析俄罗斯部分地区CHA2DS2-VASc评分较低的房颤(AF)患者的血栓栓塞事件(tee)主要危险因素患病率和抗凝治疗(ACT)处方率。材料和方法。这些信息是从Webiomed预测分析平台获得的。样本包括2016年至2019年期间在俄罗斯联邦6个组成实体的医疗机构接受治疗的87601例18-74岁AF患者(男性49.5%，平均年龄59.3±12.3岁，平均CHA 2 DS 2 -VASc评分2,3±1,5)。男性和女性的CHA 2 DS 2 VASc评分分别为1和2分，被认为是中度风险，而得分分别为0和1分，被认为是低风险的tee。结果。有22337例(25.5%)中度风险的房颤患者和18366例(21.0%)低风险的tee患者。中度tee风险的患者，CHA 2 DS 2 - vasc评分为1 / 704%的病例由高血压决定，而15.7%(65-74岁)由心力衰竭决定，9.0%(心力衰竭)由心肌梗死和/或外周动脉疾病决定，2.9%(心肌梗死和/或外周动脉疾病)由2型糖尿病决定。在房颤和tee中度风险的患者中，4927例(22.1%)患者使用ACT，而低tee风险的1833例(10.0%)患者使用ACT。在房颤和tee高危患者(n= 46898,53,5%)中，1216例(24,6%)缺血性卒中(IS)患者最初没有较高的CHA 2 ds2 -VASc风险。结论。在临床实践中，在18-74岁的房颤患者中，有相当多的个体CHA 2 DS 2 -VASc评分为1，与性别无关。这些患者需要在ACT中采取个体化的治疗方法，这是前瞻性研究的基础，以便优化心脏栓塞性is风险评估，并分析长期ACT的疗效和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Patients with atrial fibrillation and a low risk of thromboembolic events: prescription rate of anticoagulant therapy according to a retrospective analysis

Aim. To conduct a retrospective analysis of the prevalence of main risk factors for thromboembolic events (TEEs) and the prescription rate of anticoagulant therapy (ACT) in patients with atrial fibrillation (AF) and a low CHA2DS2-VASc score in certain Russian regions using artificial intelligence technologies. Material and methods . The information was obtained from the Webiomed predictive analytics platform. The sample included 87601 patients with AF aged 18-74 years (men, 49,5%, mean age, 59,3±12,3 years, mean CHA 2 DS 2 -VASc score, 2,3±1,5) who received care in medical organizations in 6 constituent entities of the Russian Federation in the period from 2016 to 2019. CHA 2 DS 2 VASc score of 1 and 2 in a man and a woman, respectively, was regarded as a moderate risk, while score of 0 and 1, respectively, as a low risk of TEEs. Results. There were 22337 (25,5%) patients with AF at moderate risk and 18366 (21,0%) patients at low risk of TEEs. With a moderate risk of TEEs, CHA 2 DS 2 -VASc score of 1 in 70,4% of cases was determined by hypertension, while in 15,7% — by age 65-74 years, in 9,0% — by heart failure, in 2,9% — by myocardial infarction and/or peripheral arterial disease, in 2,0% — by type 2 diabetes. In patients with AF and a moderate risk of TEEs, ACT was prescribed in 4927 (22,1%) patients, while with a low risk of TEEs — in 1833 (10,0%). Among patients with AF and a high risk of TEEs (n=46898, 53,5%), 1216 (24,6%) patients with ischemic stroke (IS) did not initially have a high CHA 2 DS 2 -VASc risk. Conclusion. In clinical practice, among patients with AF aged 18-74 years, there are quite often individuals with CHA 2 DS 2 -VASc score of 1 not associated with sex. These patients need an individualized approach in ACT, which is the basis for prospective studies in order to optimize the assessment of cardioembolic IS risk, as well as to analyze the efficacy and safety of long-term ACT.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.20

自引率

0.00%

发文量

185

审稿时长

1 months

期刊介绍： Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.