2018版中国房颤疾病流行病学,危害及治疗现状学习课件.ppt

INR control with VKAs could be improved in Asia and other regions. Although the optimum INR is 2.0–3.0, many patients are significantly under-anticoagulated, putting them at increased risk of thromboembolic events. This may be due to a tendency of Asian physicians to intentionally maintain a lower INR range for elderly patients due to a fear of bleeding, despite limited evidence to support this.3 The appropriate use of OACs in patients with NVAF and additional risk factors can reduce the rate of stroke by two-thirds or more.2 The RE-LY? AF registry enrolled patients who presented to an emergency department (or equivalent acute-care setting) with AF or atrial flutter, either as the primary reason for their visit or as a secondary diagnosis. The data shown here are based on the three most recent INR values before the patient presented at the emergency department.1 In the overall study population of patients worldwide with a previous history of non-rheumatic AF and a CHADS2 score of ≥2, oral anticoagulation was prescribed for only 58%, with the proportion being as low as 11% in China, where physicians have concerns about the rate of warfarin-related ICH, and disagreement exists as to the appropriate therapeutic ranges of INR.1 References 1. Oldgren J et al. Circulation 2014;129:1568–76 2. Hart HG et al. Ann Intern Med 2007;146:857–67 3. Chiang CE et al. Thromb Haemost 2014;111:789–97 新疆医科大学一附院 汤宝鹏 中国房颤疾病流行病学，危害及治疗现状 目 录 中国房颤的流行病学现状 中国房颤危害及相关卒中的经济负担 中国房颤相关卒中的治疗现状 第一部分 中国房颤的流行病学现状 01 全球范围内房颤发病率及患病率居高不下 2010年，全球共有房颤患者3350万，其中男性2090万，女性1260万；发展中国家的发病率及患病率高于发达国家； 在欧盟和美国，约1/4的中年人将罹患房颤。 估计在20岁及以上的成年人中，房颤的患病率约为3%，且患病率随着年龄及合并症的增加而升高； AF患病率的增加与甄别技术的提高有一定关系。 1.Kirchhof P et al， Eur Heart J 2016； 房颤所导致的心血管发病率及死亡率偏高 房颤相关的心血管发病率及死亡率 死亡 死亡率增加，心血管死亡率、猝死，心衰以及卒中风险增加 卒中 20%-30%的卒中由房颤引起。越来越多的卒中患者被诊断出无症状、阵发性房颤 住院率 10%-40%房颤患者需每年住院治疗 生活质量 生活质量受损 左室功能障碍及心衰 20%-30%的房颤患者合并有左室功能障碍。 认知功能下降及血管性痴呆 认知功能下降及血