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[大学生论坛]:房颤与急性冠脉综合征患者联合使用华法林与P2Y12抑制剂

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young 发表于 2017-12-30 19:50:58 | 显示全部楼层 |阅读模式
本帖最后由 young 于 2017-12-30 20:02 编辑

Combined use of warfarin and oral P2Y12 inhibitors in patients with atrial fibrillation and acute coronary syndrome.
房颤与急性冠脉综合征患者联合使用华法林与P2Y12抑制剂
Abstract
BACKGROUND:
背景:
Although atrial fibrillation (AF) occurs frequently in patients hospitalized with acute coronary syndrome (ACS), strategies for prevention of thromboembolic complications are poorly characterized.
虽然急性冠脉综合征住院患者经常发生心房颤动,但是对于肺栓塞并发症的预防策略却鲜有描述。
HYPOTHESIS:
假设:
We sought to examine exposure to warfarin and P2Y12 inhibitors and clinical outcomes among patients with AF and ACS.
我们试图研究房颤和急性冠脉综合征患者的华法林和P2Y12的使用情况以及临床转归。
METHODS:
方法:
Patients age >65 years hospitalized with a primary diagnosis of ACS and a secondary diagnosis of AF between 2007 and 2010 were identified in the Medicare 5% sample. Among patients who were alive and not readmitted during the ascertainment period, we examined the cumulative incidence of all-cause mortality and all-cause readmission by medication exposure at 1 year.
从2007年到2010年,确定了医疗保险患者中5%样本,年龄大于65岁,住院,主要诊断为急性冠脉综合征,次要诊断为房颤。在确诊期内,1633名患者存活并且未入院患者,我们研究了药物治疗1年时的全因死亡率与全因再住院率的累积发病率。
RESULTS:
结果:
A total of 2509 Medicare beneficiaries met the inclusion criteria. Among the 1633 patients (65%) who were alive and not readmitted during the 90-day ascertainment period, 24.0% received warfarin, 38.9% received P2Y12 inhibitors, 10.2% received combination therapy, and 26.8% received neither therapy. Readmission rates were high in all groups at 1 year (warfarin, 47.5%; P2Y12 inhibitors, 46.6%; combination therapy, 38.0%; and neither therapy, 39.3%), and the overall 1-year mortality rate was 12.5%.
共计2509名老年医保受益者符合纳入标准。90天确诊期内,65%,即1633名患者存活并且未入院,其中24%使用华法林,38.9%使用P2Y12抑制剂,10.2%接受联合治疗,26.8%未接受任何治疗。每个组1年再住院率居高(华法林组,47.5%;P2Y12抑制剂组,46.6%;联合治疗组,38.0%;未治疗组,39.3%),1年总死亡率为12.5%。
CONCLUSIONS:
结论:
Among Medicare beneficiaries with AF and ACS, combination therapy with warfarin and P2Y12 inhibitor was uncommon during the 90-day ascertainment period, and more than one-quarter of patients had no claims for warfarin or P2Y12 inhibitors. Rates of all-cause readmission and mortality within 1 year of hospitalization for ACS were high.
在房颤与急性冠脉综合征的老年医疗保险受益者中,90天确诊期内华法林与P2Y12抑制剂的联合治疗并不常见,超过1/4的患者并未要求使用华法林或P2Y12抑制剂。急性冠脉综合征患者的全因再住院率与1年内住院死亡率均较高。
2014级医学英语 杨晓雅 3141201051

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