Impact of preadmission anticoagulation adherent to guidelines on prognosis of the patients with atrial fibrillation

doi:10.16138/j.1673-6087.2021.06.008

Abstract

Abstract:

Objective To explore the risk of all-cause death, stroke, and bleeding in the atrial fibrillation(AF) patients with or without recommended anticoagulation preadmitting to hospital. Methods A total of 5 526 hospitalized AF patients in our hospital from September 2008 to December 2018 were enrolled and their information were analyzed retrospectively. The outcomes were confirmed according to hospitalization records, course records and discharge diagnosis, including all bleeding events, major bleeding, minor bleeding, gastric bleeding, stroke and death. Univariate and multivariate Logistic regression analysis was performed to explore the risk of end events during hospitalization. Results The patients with recommended anticoagulation（1 480, 22.78%） had lower risk of stroke [odds ratio (OR)=0.68, 95% confidence interval (CI): 0.50-0.92, P=0.01]. They had similar risk in all bleeding events, major bleeding, minor bleeding, gastric bleeding and all-cause death compared to those without recommended anticoagulation. Conclusions Recommended anticoagulation reduced the risk of all-cause death and stroke, but did not increase the risk of all bleeding events, major bleeding, minor bleeding, gastric bleeding and all-cause death.

Key words: Atrial fibrillation, Recommended anticoagulation, Bleeding, Stroke, All-cause death

CLC Number:

R514.7

BAI Ying, LIU Xinyao, ZHANG Xilin, GAO Zhaofang, SHI Xubo, DENG Kewu. Impact of preadmission anticoagulation adherent to guidelines on prognosis of the patients with atrial fibrillation[J]. Journal of Internal Medicine Concepts & Practice, 2021, 16(06): 409-412.

Figures/Tables 3

References 14

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项目	规范抗凝（n=1 480）	未规范抗凝（n=4 046）	P
年龄（岁）	61.90±11.83	74.19±10.70	<0.001
女性 [n（%）]	457（30.88）	1995（49.31）	<0.001
阵发性房颤 [n（%）]	728（52.75）	2165（58.09）	0.001
收缩压（mmHg）	124.85±17.71	132.09±19.89	<0.001
心率（次/min）	78.46±17.95	78.89±18.09	0.81
大出血史 [n（%）]	6（0.41）	45（1.11）	0.02
既往卒中病史 [n（%）]	143（9.66）	713（17.62）	<0.001
高血压病史 [n（%）]	658（44.46）	3037（75.06）	<0.001
糖尿病病史 [n（%）]	287（19.39）	1452（35.89）	<0.001
慢性肾功能不全病史 [n（%）]	108（7.30）	732（18.09）	<0.001
心力衰竭病史 [n（%）]	358（24.19）	1584（39.15）	<0.001
脂代谢异常病史 [n（%）]	623（42.09）	1814（44.83）	0.07
既往胃病病史 [n（%）]	47（3.18）	181（4.47）	0.03
左心房内径（cm）	4.01±0.83	3.97±0.73	0.16
左心室射血分数（%）	60.77±10.44	60.45±10.71	0.43

项目	未规范抗凝	规范抗凝	P
大出血
例数	143	44
未校正	1	0.84（0.59~1.18）	0.31
校正	1	1.00（0.66~1.51）	0.99
小出血
例数	230	42
未校正	1	0.49（0.35~0.68）	<0.001
校正	1	1.05（0.72~1.54）	0.79
任何出血
例数	350	82
未校正	1	0.62（0.48~0.79）	<0.001
校正	1	1.04（0.77~1.39）	0.81
消化道出血
例数	235	42
未校正	1	0.48（0.34~0.66）	<0.001
校正	1	1.05（0.72~1.53）	0.82
缺血性卒中
例数	353	65
未校正	1	0.48（0.37~0.63）	0.001
校正	1	0.65（0.47~0.88）	0.005
卒中/短暂性脑缺血发作
例数	361	72
未校正	1	0.52（0.40~0.68）	<0.001
校正	1	0.68（0.50~0.92）	0.01
全因死亡
例数	298	28
未校正	1	0.24（0.16~0.36）	<0.001
校正	1	0.66（0.42~1.02）	0.06

项目	未校正OR（95%CI）	P
大出血	0.48（0.18~1.34）	0.16
小出血	0.77（0.41~1.42）	0.39
任何出血	0.68（0.39~1.19）	0.17
胃出血	0.86（0.48~1.53）	0.60
缺血性卒中	0.80（0.41~1.57）	0.52
卒中/短暂性脑缺血发作	0.78（0.40~1.54）	0.48
全因死亡	0.36（0.17~0.75）	0.006

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