Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing

Zhen XIA; Kai LU; Xianya CHEN; Siyuan XIE; Huachao HU; Hua XIAO

doi:10.16016/j.1000-5404.202008168

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Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing

Public Health and Preventive Medicine | 更新时间：2026-01-09

- Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing
- Journal of Third Military Medical University Vol. 43, Issue 4, Pages: 347-353(2021)
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院心血管内科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.202008168
  CLC： R195.4;R541.75;R973.2
- Received：20 August 2020，
  
  Revised：2020-11-18，
  
  Published：28 February 2021
- 稿件说明：
移动端阅览
Zhen XIA, Kai LU, Xianya CHEN, et al. Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing[J]. Journal of Third Military Medical University, 2021, 43(4): 347-353.
DOI：

Zhen XIA, Kai LU, Xianya CHEN, et al. Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing[J]. Journal of Third Military Medical University, 2021, 43(4): 347-353. DOI： 10.16016/j.1000-5404.202008168.

摘要

目的

调查重庆地区二、三级医院住院患者中≥75岁老年非瓣膜性房颤患者的抗凝治疗现状。

方法

纳入重庆市19家医院(6家二级医院，13家三级医院)2018年1月1日至12月31日期间收治的3 821名≥75岁的非瓣膜性房颤患者。通过电子病历系统采集患者的临床资料。比较分析上述患者的基线资料、CHA2DS2-VASc和HAS-BLED评分、抗凝率以及抗凝药物之间的差异。

结果

所有患者的CHA2DS2-VASc评分均≥2分，HAS-BLED评分≥3分的患者占25.0%。纳入的所有房颤患者总体抗凝率为36.2%，其中采用新型口服抗凝药(new oral anticoagulants，NOAC)和华法林抗凝者分别占10.8%和25.4%，单用抗血小板治疗而未抗凝者占43.3%，未采用任何抗栓治疗者占20.5%。二级医院房颤患者中NOAC、华法林处方率明显低于三级医院(5.3%

13.0%，

0.001；16.1%

28.9%，

0.001)。

结论

重庆市二、三级医院住院患者中，≥75岁的非瓣膜性房颤患者栓塞风险较高而出血风险较低，总体抗凝率较低，二级医院较三级医院更明显。有必要采取积极措施加强相关医务人员的培训，切实提高老年房颤患者的抗凝率。

Abstract

Objective

To investigate the current status of anticoagulation therapy for the elderly patients aged 75 years or over with non-valvular atrial fibrillation in secondary and tertiary hospitals in Chongqing.

Methods

A total of 3 821 patients aged 75 years old or over with non-valvular atrial fibrillation from 19 hospitals (6 secondary hospitals and 13 tertiary hospitals) in Chongqing between January 1

2018 and December 31

2018 were enrolled in this study. The clinical data of patients were collected by electronic medical record system. Their baseline data

scores of CHA2DS2-VASc and HAS-BLED

anticoagulant rate and anticoagulant drugs were compared and analyzed.

Results

All the patients had their CHA2DS2-VASc score ≥2

and those with HAS-BLED score ≥3 accounted for 25.0%. The overall anticoagulant rate was 36.2%. And of these patients

10.8% and 25.4% were treated with new oral anticoagulants (NOAC) and warfarin respectively

43.3% were treated with antiplatelet alone without anticoagulant

and 20.5% were not treated with any antithrombotic therapy. The prescription rate of NOAC and warfarin in these patients was much lower in secondary hospitals than tertiary hospitals (5.3%

13.0%

0.001; 16.1%

28.9%

0.001).

Conclusion

Among the inpatients in the secondary and tertiary hospitals of Chongqing

those aged 75 years or over with non-valvular atrial fibrillation have higher risk of embolism

lower risk of bleeding

but lower overall anticoagulation rate

especially in the secondary hospital when compared with the tertiary hospital. It is necessary to take positive measures to strengthen the training of relevant doctors in order to effectively improve the anticoagulation rate in these patients.

关键词

Keywords

references

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