• 作者：Moisé ; s Rodrí ; guez-Mañ ; ero^a ; ^{mrodrigu@uzbrussel.be} ; Alberto Cordero^b ; Vicente Bertomeu-Gonzá ; lez^b ; José ; Moreno-Arribas^b ; Vicente Bertomeu-Martí ; nez^b ; Pilar Mazó ; n^c ; Lorenzo Fá ; cila^d ; Juan Cosí ; n^e ; Iñ ; aki Lekuona^f ; Enrique Galve^g ; José ; R. Gonzá ; lez-Juanatey^c
• 关键词：ACO ; anticoagulació ; n oral ; ACV ; accidente cerebrovascular ; DM ; diabetes mellitus ; FA ; fibrilació ; n auricular ; HTA ; hipertensió ; n arterial ; IC ; insuficiencia cardiaca
• 刊名：Revista Espa帽ola de Cardiolog铆a
• 出版年：2011
• 期刊代码：pca308_03008932
• 类别：med
• 出版时间：August 2011
• 卷：64
• 期：8
• 页码：649-653
• 文件大小：162 K

Introduction and objectives

The guidelines for the management of atrial fibrillation (AF) incorporate new risk factors for thromboembolism, trying to de-emphasize the use of the 鈥榣ow鈥? 鈥榤oderate鈥? and 鈥榟igh鈥?risk categories. The objective of this study was to determine the impact of the new scheme CHA₂DS₂-VASc and of the new recommendations for oral anticoagulation (OAC) in a contemporary sample of patients with AF seen by primary physicians and cardiologists.

Methods

Multicenter, observational, cross-sectional study on the epidemiology of hypertension and its control, designed by the arterial hypertension department. Each researcher enrolled the first 6 consenting patients who came for examination during a 5-day period.

Results

Of 25 137 individuals recruited, 1544 were diagnosed with AF. The vast majority of the sample had a CHADS₂ score 鈮? (77.3%). Individuals with a risk score lower than 2 were categorized according to the CHA₂DS₂-VASc score: 14.4%were aged 75 years or older (CHA₂DS₂-VASc = 2). Of those younger than 75, 42.3%had a CHA₂DS₂-VASc = 2; 23.7%CHA₂DS₂-VASc = 3, and 1.1%CHA₂DS₂-VASc = 4. This means that the 85.1%of the patients with a CHADS₂ score <2 and no contraindications are indicated for OAC.

Conclusions

The new recommendations will result in a significant increase in patients with indications for OAC, at the expense of those previously characterized as low-to-moderate risk. Therefore, patients at risk of thromboembolic events must be identified, although an evaluation of bleeding risk should be part of the patient assessment before starting anticoagulation.

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