中东地区心房颤动患者遵守 2019 年 AHA/ACC/HRS 重点更新的《2014 年 AHA/ACC/HRS 口服抗凝药物使用指南》的情况:约旦心房颤动(JoFib)研究。

IF 2.5 Q2 PERIPHERAL VASCULAR DISEASE
International Journal of Vascular Medicine Pub Date : 2021-04-08 eCollection Date: 2021-01-01 DOI:10.1155/2021/5515089
Ayman J Hammoudeh, Yousef Khader, Nazih Kadri, Eyas Al-Mousa, Yahya Badaineh, Laith Habahbeh, Ramzi Tabbalat, Hesham Janabi, Imad A Alhaddad
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引用次数: 0

摘要

背景:很少有研究对中东地区心房颤动(AF)患者使用指南推荐的口服抗凝剂(OAC)的情况进行评估。约旦房颤(JoFib)研究根据 2014 年 AHA/ACC/HRS 指南的 2019 年重点更新版,评估了瓣膜性房颤(VAF)和非瓣膜性房颤(NVAF)患者的基线临床概况和 OACs(包括维生素 K 拮抗剂(VKAs)和直接 OACs(DOACs))的使用情况:方法:29 家医院和门诊诊所招募了连续的房颤患者。结果:在 2000 名患者中,177 人(8%)使用了 OACs:在 2000 名患者中,177 人(8.9%)患有 VAF,1823 人(91.1%)患有 NVAF。在 VAF 组中,88.1% 的患者接受了 VKA 治疗。在 NVAF 组中,1468 名(80.5%)患者的 CHA2DS2-VASc 得分较高,即女性≥3 分,男性≥2 分;202 名(11.1%)患者的 CHA2DS2-VASc 得分中等,即女性 2 分,男性 1 分;153 名(8.4%)患者的 CHA2DS2-VASc 得分较低,即女性 1 分,男性 0 分。在 CHA2DS2-VASc 得分较高的患者中,1204 人(82.0%)接受了 OACs 治疗,其中 784 人(53.4%)接受了 DOACs 治疗,420 人(28.6%)接受了 VKA 治疗。在中等评分患者中,148 名(73.3%)患者接受了 OACs 治疗,其中 107 名(53.0%)患者接受了 DOACs 治疗,41 名(20.3%)患者接受了 VKA 治疗。在低分患者中,94 名(61.4%)患者未使用 OACs,59 名(38.6%)患者使用了 OACs。多变量分析显示,年龄在50至70岁之间、CHA2DS2-VASc评分≥2分、诊断为中风或全身性栓塞以及非阵发性房颤与OAC处方几率增加显著相关:中东地区房颤患者使用 OACs 的现状似乎很有希望,并且与 2014 年 AHA/ACC/HRS 指南的 2019 年重点更新一致。该试验已在 NCT03917992 上注册。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study.

Adherence to the 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline on the Use of Oral Anticoagulant Agents in Middle Eastern Patients with Atrial Fibrillation: The Jordan Atrial Fibrillation (JoFib) Study.

Background: There is a scarcity of studies that evaluate adherence to the utilization of guideline-recommended oral anticoagulant agents (OACs) in patients with atrial fibrillation (AF) in the Middle East. The Jordan Atrial Fibrillation (JoFib) Study evaluated baseline clinical profiles and the utilization of OACs, including vitamin K antagonists (VKAs) and direct OACs (DOACs), in patients with valvular AF (VAF) and nonvalvular AF (NVAF) according to the 2019 focused update of the 2014 AHA/ACC/HRS guidelines.

Methods: Consecutive patients with AF were enrolled in 29 hospitals and outpatient clinics. The use of OACs was evaluated in patients with VAF and NVAF according to the prespecified guideline.

Results: Of 2000 patients, 177 (8.9%) had VAF and 1823 (91.1%) had NVAF. A VKA was prescribed for 88.1% of the VAF group. In the NVAF group, 1468 (80.5%) of patients had a high CHA2DS2-VASc score, i.e., a score of ≥3 in women and ≥2 in men; 202 (11.1%) patients had an intermediate CHA2DS2-VASc score, i.e., a score of 2 in women and 1 in men; and 153 (8.4%) patients had a low CHA2DS2-VASc score, i.e., a score of 1 in women and 0 in men. Of patients with a high CHA2DS2-VASc score, 1204 (82.0%) received OACs, including DOACs for 784 (53.4%) and VKA for 420 (28.6%) patients. Among patients with an intermediate score, OACs were prescribed for 148 (73.3%) patients, including 107 (53.0%) who received DOACs and 41 (20.3%) patients who received VKA. In patients with a low score, OACs were omitted in 94 (61.4%) patients and prescribed for 59 (38.6%) patients. Multivariate analysis showed that age between 50 and 70 years, CHA2DS2-VASc score of ≥2, a diagnosis of stroke or systemic embolization, and nonparoxysmal AF were significantly associated with increased odds of OAC prescription.

Conclusions: The current status of the utilization of OACs in Middle Eastern AF patients appears to be promising and is consistent with the 2019 focused update of the 2014 AHA/ACC/HRS guideline. This trial is registered with NCT03917992.

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来源期刊
International Journal of Vascular Medicine
International Journal of Vascular Medicine PERIPHERAL VASCULAR DISEASE-
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16 weeks
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