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• W4377011503 abstract "Objective: To investigate current use of oral anticoagulant (OAC) therapy and influencing factors among coronary artery disease (CAD) patients with nonvalvular atrial fibrillation (NVAF) in China. Methods: Results of this study derived from China Atrial Fibrillation Registry Study, the study prospectively enrolled atrial fibrillation (AF) patients from 31 hospitals, and patients with valvular AF or treated with catheter ablation were excluded. Baseline data such as age, sex and type of atrial fibrillation were collected, and drug history, history of concomitant diseases, laboratory results and echocardiography results were recorded. CHA2DS2-VASc score and HAS-BLED score were calculated. The patients were followed up at the 3rd and 6th months after enrollment and every 6 months thereafter. Patients were divided according to whether they had coronary artery disease and whether they took OAC. Results: 11 067 NVAF patients fulfilling guideline criteria for OAC treatment were included in this study, including 1 837 patients with CAD. 95.4% of NVAF patients with CAD had CHA2DS2-VASc score≥2, and 59.7% of patients had HAS-BLED≥3, which was significantly higher than NVAF patients without CAD (P<0.001). Only 34.6% of NVAF patients with CAD were treated with OAC at enrollment. The proportion of HAS-BLED≥3 in the OAC group was significantly lower than in the no-OAC group (36.7% vs. 71.8%, P<0.001). After adjustment with multivariable logistic regression analysis, thromboembolism(OR=2.48,95%CI 1.50-4.10,P<0.001), left atrial diameter≥40 mm(OR=1.89,95%CI 1.23-2.91,P=0.004), stain use (OR=1.83,95%CI 1.01-3.03, P=0.020) and β blocker use (OR=1.74,95%CI 1.13-2.68,P=0.012)were influence factors of OAC treatment. However, the influence factors of no-OAC use were female(OR=0.54,95%CI 0.34-0.86,P=0.001), HAS-BLED≥3 (OR=0.33,95%CI 0.19-0.57,P<0.001), and antiplatelet drug(OR=0.04,95%CI 0.03-0.07,P<0.001). Conclusion: The rate of OAC treatment in NVAF patients with CAD is still low and needs to be further improved. The training and assessment of medical personnel should be strengthened to improve the utilization rate of OAC in these patients.目的： 评价冠心病合并非瓣膜性心房颤动（NVAF）患者口服抗凝药物（OAC）使用情况以及影响因素。 方法： 研究对象来自中国心房颤动注册研究。该研究于北京市31家医院前瞻性纳入心房颤动患者，排除瓣膜性心房颤动和接受导管消融治疗患者。收集患者的年龄、性别、房颤类型等基线资料，记录用药史、合并疾病史、实验室检查结果和超声心动图检查结果。计算CHA2DS2-VASc评分和HAS-BLED积分。在入组第3、6个月及之后每6个月对患者进行随访。根据有无冠心病及是否服用OAC对患者进行分组。组间比较采用独立样本t检验或Wilcoxon秩和检验。将各因素纳入logistic二元及多元回归分析，探索影响患者服用OAC因素。以P<0.05为差异有统计学意义。 结果： 纳入需要OAC治疗的NVAF患者11 067例，其中合并冠心病患者1 837例。NVAF合并冠心病患者中CHA2DS2-VASc评分≥2分的比例为95.4%，HAS-BLED积分≥3分的比例为59.7%，均明显高于无冠心病组（P均<0.001）。纳入研究时OAC使用率仅为34.6%。OAC组患者HAS-BLED积分≥3分比例明显低于未用OAC的患者（36.7%比71.8%，P<0.001）。多因素logistic回归分析发现，影响服用OAC的因素有血栓栓塞（OR=2.48，95%CI：1.50~4.10，P<0.001）、左心房内径≥40 mm（OR=1.89，95%CI：1.23~2.91，P=0.004）、服用他汀（OR=1.83，95%CI：1.10~3.03，P=0.020）和服用β受体阻滞剂（OR=1.74，95%CI：1.13~2.68，P=0.012）；影响未用OAC的因素有女性（OR=0.54，95%CI：0.34~0.86，P=0.001）、HAS-BLED积分≥3分（OR=0.33，95%CI：0.19~0.57，P<0.001）和服用抗血小板药物（OR=0.04，95%CI：0.03~0.07，P<0.001）。 结论： 冠心病合并NVAF患者OAC的使用率仍然较低，有待进一步提高。应加强医务人员的培训和考核，提高OAC使用率。." @default.
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• W4377011503 date "2023-05-24" @default.
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• W4377011503 title "[Current use of oral anticoagulation therapy and influencing factors among coronary artery disease patients with nonvalvular atrial fibrillation in China]." @default.
• W4377011503 doi "https://doi.org/10.3760/cma.j.cn112148-20230301-00111" @default.
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