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ヨシダ タクオ
YOSHIDA Takuo
吉田 拓生 所属 医学部 医学科（東京女子医科大学病院） 職種 非常勤講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Clinical prediction scores and early anticoagulation therapy for new-onset atrial fibrillation in critical illness: a post-hoc analysis. |
| 掲載誌名 | 正式名：BMC cardiovascular disorders 略 称：BMC Cardiovasc Disord ISSNコード：14712261/14712261 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 21(1),pp.423 |
| 著者・共著者 | Sakuraya Masaaki, Yoshida Takuo, Sasabuchi Yusuke, Yoshihiro Shodai, Uchino Shigehiko |
| 担当区分 | 2nd著者 |
| 発行年月 | 2021/09 |
| 概要 | PURPOSE:This study sought to describe the epidemiology of anticoagulation therapy for critically ill patients with new-onset atrial fibrillation (NOAF) according to CHA2DS2-VASc and HAS-BLED scores and to assess the efficacy of early anticoagulation therapy.METHOD:Adult patients who developed NOAF during intensive care unit stay were included. We compared the patients who were treated with and without anticoagulation therapy within 48 h from AF onset. The primary outcome was a composite outcome that included mortality and ischemic stroke during the period until hospital discharge.RESULTS:In total, 308 patients were included in this analysis. Anticoagulants were administered to 95 and 33 patients within 48 h and after 48 h from NOAF onset, respectively. After grouping the patients into four according to their CHA2DS2-VASc and HAS-BLED bleeding scores, we found that the proportion of anticoagulation therapy administered was similar among all groups. After adjustment using a multivariable Cox regression model, we noted that early anticoagulation therapy did not decrease the composite outcome (adjusted hazard ratio [HR] 0.77; 95% confidence interval [CI] 0.47‒1.23). However, in patients without rhythm control drugs, early anticoagulation was significantly associated with better outcomes (adjusted HR 0.46; 95% CI; 0.22‒0.87, P = 0.041).CONCLUSIONS:We found that clinical prediction scores were supposedly not used in the decision to implement anticoagulation therapy and that early anticoagulation therapy did not improve clinical outcomes in critically ill patients with NOAF. Trial registration UMIN-CTR UMIN000026401. Registered 5 March 2017. |
| DOI | 10.1186/s12872-021-02235-8 |
| PMID | 34496749 |