| Objective: To understand the clinical features and treatment of non-valvular atrial fibrillation(NVAF)patients in 2011 and 2016 in tertiary hospitals in chenzhou area.Analyze the factors affecting standardized treatment and further improve the quality of diagnosis and treatment.Methods: A total of 2 tertiary hospitals in chenzhou City used a unified questionnaire to record all NVAF patients in both hospitals in 2011 and 2016,collected basic data,treatment measures,and ventricular rate information,and followed up the 1-year prognosis after discharge.Results: A total of 482 NVAF cases were obtained,including 118 in 2011 and 364 in 2016.Compared with 2011,there was no significant difference in the proportion of age and gender of NVAF patients in 2016;the number of patients from rural areas increased significantly,and the proportion was 43.2%.There was no significant difference in the proportions of hypertension,diabetes,chronic heart failure,stroke,and vascular disease with the risk factors of %,61.0%(P=0.001).There was no significant difference in the proportion of risk factors for hypertension,diabetes,chronic heart failure,stroke,vascular disease,smoking,alcohol consumption,and COPD among NVAF patients in 2011 and 2016.In 2011 and 2016,the proportion of people who received the CHA2DS2-VASc system score in the NVAF patients accounted for 29.7% and 50.6% of the total number of people enrolled in the year.(P<0.001).There was no significant difference in the risk factors of the CHA2DS2-VASc system score among NVAF selected cases.The proportions of hypertension,diabetes,age,stroke history,congestive heart failure,vascular disease,and gender were not significantly different.Compared with 2011,there was no significant difference in the proportion of patients treated with radiofrequency ablation during NVAF cardioversion and maintenance of sinus rhythm in 2016.The difference was not statistically significant.There was no significant difference in the proportion of cardioversion for amiodarone and propafenone.The difference was not statistically significant.In 2011 and 2016,a total of 172 patients were selected for anticoagulant therapy and the proportion of anticoagulant therapy was increased.They were 29 and 143,respectively,which accounted for 24.6% and 39.3% of the total enrolled in the current year(P=0.004).Compared with 2011,the proportion of warfarin,rivaroxaban,and dabigatran etexilate in NVAF patients in 2016 represented no significant difference in the proportion of total anticoagulant therapy in the current year,which was not statistically significant.The PT/INR monitoring rates of anticoagulants used in 2011 and 2016 were 65.5% and 68.5%,respectively,with no significant difference.The difference was not statistically significant.Compared with 2011,patients who were discharged from hospital with β-blockers,diltiazem,digoxin drugs,and digoxin plus beta blockers combined with diltiazem plus digoxin for control of ventricular rate in 2016 accounted for the current year The proportion of the total number did not change significantly,and the difference was not statistically significant.The ratio of resting ventricular rate <110 beats/minute and ventricular rate> 110 beats/minute to the total number of people in NFAF patients during discharge in 2011 and 2016 within one year were: 83.2%,86.4%;16.8%,13.6%.,respectively.The difference was not statistically significant.The poor prognosis of NVAF patients in 2011 and 2016 included one-year post-discharge all-cause mortality + ventricular rate ≥110 beats/min + stroke + 1 year after admission.In 2011,there were 107 patients with follow-up information,including 3 deaths.(accounting for 2.8%),19 patients(accounting for 17.8%)were re-introduced within 1 year(6.0%),and 6 stroke patients(accounting for 5.6%).There were 339 patients with follow-up information in 2016,including 7 deaths(2.1%).)The number of re-admissions was 124(36.6%)in 1 year,and 15 strokes(4.4%).Compared with 2011,the proportion of re-hospitalization of NVAF patients in 1 year increased significantly in 2016(P<0.001).There was no significant difference in stroke and mortality,and there was no statistical significance.Conclusions: 1.Compared with 2011,the evaluation rate of thromboembolic risk was significantly increased in NVAF patients in tertiary hospitals in Chenzhou District in 2016,and the anticoagulant treatment rate was significantly increased.2.Compared with 2011,there was no significant change in the rate of resting heart rate attainment during the first year in NVAF patients who used controlled ventricular rate drugs in tertiary hospitals in 2016.3.Compared with 2011,there was no significant difference in the stroke rate and all-cause mortality rate among NVAF patients in tertiary hospitals in Chenzhou in 2016. |
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