[Chinese subgroup analysis of the global anticoagulant registry in the FIELD (GARFIELD) registry in the patients with non-valvular atrial fibrillation].
Zhonghua xin xue guan bing za zhi(2014)
摘要
OBJECTIVE:To describe the baseline characteristics and antithrombotic treatment of patients with non-valvular atrial fibrillation in the Chinese subgroup of GRAFIELD.
METHODS:GARFIELD is an observational registry study for patients with newly diagnosed non-valvular atrial fibrillation. A total of 805 adult ( ≥18 years old) patients (mean age: (66.6 ± 11.4) years old, 39.4% female (n = 317)) diagnosed with non-valvular atrial fibrillation within the previous 6 weeks were recruited between December 2009 and October 2011 at 29 hospitals from China. Baseline data included demographics, medical history, nature of atrial fibrillation, CHA(2)DS(2) score, CHA(2)DS(2)-VASc score, and treatment at the time of diagnosis.
RESULTS:There were 216 patients (26.8%) with age above 75 years old, 116 patients (14.4%) had history of stroke or TIA, 261 patients (32.4%) had coronary artery disease. Mean CHADS(2) score was 1.7 ± 1.1, and 391 patients (48.5%) had a CHADS(2) score ≥ 2. Mean CHA(2)DS(2)-VASc score was 2.9 ± 1.7, and 630 patients (78.3%) had a CHA(2)DS(2)-VASc score ≥ 2.Overall, 159 patients (19.8%) received no anticoagulant treatment, 51.6% (n = 415) patients received aspirin and only 28.7% (n = 231) patients received either warfarin (n = 179, 22.2%) or new oral anticoagulants (NOAC) (n = 52, 6.5%). Among patients with CHADS2 score ≥ 2 (n = 391), 68.3% patients (n = 267) did not receive anticoagulant therapy. Among patients with CHA(2)DS(2)-VASc ≥ 2 (n = 630), 71.7% (n = 452) did not receive anticoagulant therapy. For the patients with very high risk of stroke, i.e. CHA(2)DS(2)-VASc ≥ 6, the proportion of the patients received NOAC and warfarin were identical (14.9%, 7/47).
CONCLUSIONS:This contemporary observational registry study shows that the anticoagulant therapy is somehow improved but still underused in Chinese NVAF patients. Stroke prevention according to risk scores and current guidelines in these patients remains an important task in China.
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