| Objective: With the purpose of understanding current situation of the primary prevention of stroke in patients with nonvalvular atrial fibrillation and provide a theoretical basis for further improvement.Methods: A total of 908 patients admitted in Sichuan Provincial People's Hospital between December 2013 and August 2015 was included into this retrospective study.we analyzed the basic characteristics of all included studies,and the awareness,treatment and control of the stroke risk factors in patients with nonvalvular atrial fibrillation,and evaluated the medication/surgery therapy or other therapy in patients with high risk of stroke.Statistical analyses were performed using SPSS software,version17.0(SPSS,Inc.).Continuous variables were given as mean ±standard deviation and the categorical variables were given as percentages.All P-value were two-side and significant difference was set at P-values < 0.05.Results: 1)A total of 908 patients were analyzed finally,which including 482(53.1%)men and 426(42.9%)women.Mean age was 72.2±11.21 years.2)High blood pressure,diabetes and dyslipidemia were the most common risk factors of stroke.A total of 908 people,498 people were suffering from high blood pressure.The rate of awareness of hypertension was 89.8%,about 42.5% receviving treatment and 26.9% having controlled.The rate of awareness about diabetes was 80.3% within the 188 people;the rate of treatment was 36.7%;the rate of control was 15.4%.And 10.3% of 301 people with dyslipidemia were aware of this illness,but only 3.3% receiving treatment and only 2.3% having controlled.Patients with nonvalvular atrial fibrillation without any risk factors were 253(27.9%),with 1 were 384(42.3%),with 2 were 210(23.1%),with 3 were 61(6.7%).3)We used the CHA2DS2-VASc score to assess the risk of stroke within the 908 people and a score of 2 or more is high-risk groups.In this investigation,58 patients had a CHA2DS2-VASc score =0,in these people 16 patients(27.6%)took anticoagulant therapy,21 patients(36.2%)took antiplatelet.124 patients had a CHA2DS2-VASc score =1.In these people 15 patients(12.1%)took anticoagulant therapy and 66 patients(53.2%)took antiplatelet.726 patients had a CHA2DS2-VASc score ?2,in these people 118(16.3%)patients took anticoagulant therapy;329(54.0%)patients took antiplatelet;6(0.8%)people accepted left atrial appendage closure(LAAC).4)We analyzed the 726 people with the CHA2DS2-VASc score?2,who had the high risk of stroke.Patients(36.8%)of those people ? 54 years,took anticoagulant therapy and 47.4% took antiplatelet;55-64 years of the people with high risk stroke had 15.9% took anticoagulant therapy and 65.1% took antiplatelet;22.6% of people between 64 to 74 years took anticoagulant therapy and 47.4% took antiplatelet;people who was ?75 years,only 11.8% took anticoagulant therapy and 56.3% took antiplatelet.5)Patients with pre-hospital anticoagulant drugs about the INR target:26(96.1%)people had the INR?2.0,1(3.9%)people had INR 2.0-3.0 and without any people had the INR>3.0.Conclusion: In Chengdu Patients with NVAF had a high rate of quitting smoking and higher proportion of overweight and obesity.Most of patients with nonvalvular atrial fibrillation had some high risk factors of stroke.The rate of treatment and control of their risk factors including hypertension,diabetes and dyslipidemia among the total people was low,especially the people with dyslipidemia.Besides,people with dyslipidemia had the low rate of awareness.The rate of anticoagulant therapy in patients with high risk of stroke was significantly low,especially for old patients,but the rate of antiplatelet therapy was higher than the rate of anticoagulant therapy.Therefore primary prevention of stroke in patients with nonvalvular atrial fibrillation need to be improved for a further step. |
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