Anticoagulant therapy in atrial fibrillation with acute coronary syndrome in real clinical practice according to the total register of acute coronary syndrome in the Krasnodar Territory
Abstract:Антикоагулянтная терапия при фибрилляции предсердий на фоне острого коронарного синдрома в реальной клинической практике по данным тотального регистра острого коронарного синдрома по Краснодарскому краю Ключевые слова: антитромбоцитарные препараты, геморрагические осложнения, оральные антикоагулянты, острый коронарный синдром, регистр, тромбоэмболические осложнения, фибрилляция предсердий
“…At the beginning of this research, the prescription rate of ATT was 6.7%, and it was higher than the prescription rate of ATT received in the 2013–2014 CAMI research in China, where it was 1.7% [ 22 ] and much lower than indicated in the research of Z. G. Tatarintseva et al [ 23 ], conducted in Krasnodar Krai, where the frequency of TATT prescription in the period of 2015–2017 was 62.8%, and the work of M.V. Solovieva and S.A. Boldueva [ 21 ], conducted in the period of 2013–2018 in St. Petersburg, where this index was 80.5%.…”
Section: Discussionmentioning
confidence: 68%
“…However, the researchers evaluated the long-term prognosis for the entire period after discharge (mean 2.3 ± 1.9 years, maximum 7.2 years) when comparing the group of patients who did not take anticoagulants after discharge or administered them in the incorrect doses, patients who took anticoagulants adequately had significant differences in the onset of cardiovascular events compared to the patients who took anticoagulants inadequately. In case of incorrect intake or cancellation of anticoagulants, there was an increased risk of CS and a CEP: recurrent MI and CS and cardiovascular mortality [ 23 ].…”
Background and Objectives: The problem of treating patients with atrial fibrillation and myocardial infarction is relevant. The issue of optimal antithrombotic therapy in these patients has not been definitively resolved. This work analyzes the influence of clinical factors and treatment on the long-term prognosis of patients. Materials and Methods: The research included 360 patients with atrial fibrillation and myocardial infarction during 2016–2019. Results: The factors associated with fatal outcomes were age (hazard ratio (HR): 1.05; 95% confidence interval (CI): 1.03–1.07; p < 0.001); stroke (HR: 1.95; 95% CI: 1.27–3.00; p = 0.0002); glomerular filtration rate (HR: 0.988; 95% CI: 0.978–0.998; p = 0.03); left ventricular ejection fraction (HR: 0.975; 95% CI: 0.957–0.999; p = 0.007); and aspirin (HR: 0.48; 95% CI: 0.31–0.73; p < 0.001). The factors associated with the combined endpoint were chronic kidney disease (HR: 1.46; 95% CI: 1.01–2.10; p = 0.04); HAS-BLED (HR: 1.23; 95% CI: 1.06–1.43; p = 0.007); percutaneous coronary intervention (HR: 0.70; 95% CI: 0.51–0.96; p = 0.03); and aspirin (HR: 0.65; 95% CI: 0.44–0.97; p = 0.03). Conclusions: Double and triple antithrombotic therapy were not associated with outcomes. Aspirin improved the prognosis for survival and the combined endpoint.
“…At the beginning of this research, the prescription rate of ATT was 6.7%, and it was higher than the prescription rate of ATT received in the 2013–2014 CAMI research in China, where it was 1.7% [ 22 ] and much lower than indicated in the research of Z. G. Tatarintseva et al [ 23 ], conducted in Krasnodar Krai, where the frequency of TATT prescription in the period of 2015–2017 was 62.8%, and the work of M.V. Solovieva and S.A. Boldueva [ 21 ], conducted in the period of 2013–2018 in St. Petersburg, where this index was 80.5%.…”
Section: Discussionmentioning
confidence: 68%
“…However, the researchers evaluated the long-term prognosis for the entire period after discharge (mean 2.3 ± 1.9 years, maximum 7.2 years) when comparing the group of patients who did not take anticoagulants after discharge or administered them in the incorrect doses, patients who took anticoagulants adequately had significant differences in the onset of cardiovascular events compared to the patients who took anticoagulants inadequately. In case of incorrect intake or cancellation of anticoagulants, there was an increased risk of CS and a CEP: recurrent MI and CS and cardiovascular mortality [ 23 ].…”
Background and Objectives: The problem of treating patients with atrial fibrillation and myocardial infarction is relevant. The issue of optimal antithrombotic therapy in these patients has not been definitively resolved. This work analyzes the influence of clinical factors and treatment on the long-term prognosis of patients. Materials and Methods: The research included 360 patients with atrial fibrillation and myocardial infarction during 2016–2019. Results: The factors associated with fatal outcomes were age (hazard ratio (HR): 1.05; 95% confidence interval (CI): 1.03–1.07; p < 0.001); stroke (HR: 1.95; 95% CI: 1.27–3.00; p = 0.0002); glomerular filtration rate (HR: 0.988; 95% CI: 0.978–0.998; p = 0.03); left ventricular ejection fraction (HR: 0.975; 95% CI: 0.957–0.999; p = 0.007); and aspirin (HR: 0.48; 95% CI: 0.31–0.73; p < 0.001). The factors associated with the combined endpoint were chronic kidney disease (HR: 1.46; 95% CI: 1.01–2.10; p = 0.04); HAS-BLED (HR: 1.23; 95% CI: 1.06–1.43; p = 0.007); percutaneous coronary intervention (HR: 0.70; 95% CI: 0.51–0.96; p = 0.03); and aspirin (HR: 0.65; 95% CI: 0.44–0.97; p = 0.03). Conclusions: Double and triple antithrombotic therapy were not associated with outcomes. Aspirin improved the prognosis for survival and the combined endpoint.
“…Что касается динамики назначения ОАК при ИМ в сочетании с ФП, то таких работ в доступных нам литературных источниках немного. В частности, в ретроспективном анализе историй болезни 13244 пациентов, поступивших в инфарктные отделения всех без исключения населенных пунктов Краснодарского края и включенных в регистр острого коронар-ного синдрома по Краснодарскому краю с 20 ноября 2015г по 20 ноября 2017г, частота назначения ОАК при ФП составила 62,8% [14], что ненамного выше, чем в нашем исследовании (54,7%).…”
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