Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiacarrhythmia in clinical practice, which if untreated results in a doubling of cardiovascularmorbidity and mortality. AF is an independent predi...Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiacarrhythmia in clinical practice, which if untreated results in a doubling of cardiovascularmorbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 timeshigher than patients in sinus rhythm. During recent years, several randomised clinical trialsconducted by investigators around the world involving 13 843 participants with NVAF havedemonstrated convincingly the value of warfarin therapies for stroke prevention in high riskpatients. However, the dose response of warfarin is complex and its activity is easily altered byconcurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice androutine monitoring of the international normalized ratio (INR) is important, because lowanticoagulant intensity predisposes the patients to thromboembolic complications and high intensityto haemorrhage. Studies suggested that anticoagulant clinics could improve the quality ofanticoagulation control, and anticoagulant clinics are common in western countries. However, inChina, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, whilethe quality of anticoagulation control is never investigated. We therefore assessed anticoagulationcontrol in the outpatient clinic of cardiology, and the quality of anticoagulation control since theestablishment of anticoagulant clinics.展开更多
文摘Nonvalvular atrial fibrillation (NVAF) is the most common sustained cardiacarrhythmia in clinical practice, which if untreated results in a doubling of cardiovascularmorbidity and mortality. AF is an independent predictor of stroke, with an annual risk 5 to 6 timeshigher than patients in sinus rhythm. During recent years, several randomised clinical trialsconducted by investigators around the world involving 13 843 participants with NVAF havedemonstrated convincingly the value of warfarin therapies for stroke prevention in high riskpatients. However, the dose response of warfarin is complex and its activity is easily altered byconcurrent medications, food interactions, alcohol and illnesses. Adherence to medical advice androutine monitoring of the international normalized ratio (INR) is important, because lowanticoagulant intensity predisposes the patients to thromboembolic complications and high intensityto haemorrhage. Studies suggested that anticoagulant clinics could improve the quality ofanticoagulation control, and anticoagulant clinics are common in western countries. However, inChina, most AF patients taking warfarin usually attend the outpatient clinic of cardiology, whilethe quality of anticoagulation control is never investigated. We therefore assessed anticoagulationcontrol in the outpatient clinic of cardiology, and the quality of anticoagulation control since theestablishment of anticoagulant clinics.
