Chinese Medical Journal (Jan 2024)

Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

  • Jing Lin,
  • Deyong Long,
  • Chenxi Jiang,
  • Caihua Sang,
  • Ribo Tang,
  • Songnan Li,
  • Wei Wang,
  • Xueyuan Guo,
  • Man Ning,
  • Zhaoqing Sun,
  • Na Yang,
  • Yongchen Hao,
  • Jun Liu,
  • Jing Liu,
  • Xin Du,
  • Louise Morgan,
  • Gregg C. Fonarow,
  • Sidney C. Smith, Jr,
  • Gregory Y.H. Lip,
  • Dong Zhao,
  • Jianzeng Dong,
  • Changsheng Ma,
  • On behalf of CCC-AF investigators,
  • Rongman Jia,
  • Xiuyuan Hao

DOI
https://doi.org/10.1097/CM9.0000000000002915
Journal volume & issue
Vol. 137, no. 2
pp. 172 – 180

Abstract

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Abstract. Background:. Oral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China. Methods:. Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed. Results:. A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43–0.68; P 70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov, NCT02309398.