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Daten aus dem globalen Register zur Behandlung von Vorhofflimmern zeigen, dass antithrombotische Wirkstoffe zur Verhinderung von Schlaganfällen nicht optimal genutzt werden
Date:9/2/2014

hielten (von 57,5 % auf 41,1 %).

Die 12.448 prospektiven Patienten mit mindestens einem Jahr Follow-up-Daten nach der VF-Diagnose zum Zeitpunkt der Analyse wurden in die drei Poster, die auf dem ESC-Kongress 2014 vorgestellt werden, miteinbezogen.

Nur 25 % der mit VKA behandelten Patienten erreichen eine angemessene Antikoagulanzienkontrolle[3]  

  • Die ESC-Leitlinien legen nahe, dass Patienten mit VKA als gut eingestellt betrachtet werden können, wenn sie während der Behandlung mindestens 70 % der Zeit innerhalb des therapeutischen Bereichs liegen, d. h. einen INR-Wert (International Normalized Ratio) zwischen 2,0 und 3,0[4] aufweisen.
  • Die Erfordernis für Patienten, die gerinnungshemmende Medikamente einnehmen, eine regelmäßige Routine-Untersuchung und Dosis-Einstellung durchführen zu lassen und die Schwierigkeit, die optimale gerinnungshemmende Wirkung aufrecht zu erhalten, sind wichtige Kriterien, die bei der Wahl der Antikoagulanzientherapien berücksichtigt werden müssen. Bei den NOAKs werden gleichbleibende Dosen verabreicht, und die gerinnungshemmende Wirkung ist vorhersehbar, ohne überwacht werden zu müssen.
  • Von den 5.107 GARFIELD-AF-Patienten, die mit VKA behandelt wurden und von denen INR-Aufzeichnungen vorlagen, erreichten nur 25 % (n=1301) den 70 %-Standard für die VKA-Kontrolle (wobei die INR-Kontrolle als Frequenzbereich gemessen wurde).
  • Patienten, deren VKA-Kontrolle suboptimal war, unterlagen einem signifikant höheren Herzinfarkt-, Blutungsereignis- oder Sterblichkeitsrisiko.

2 von 5 Niedrigrisiko-Patienten erhalten entgegen Leitlinienempfehlungen eine Antikoagulanzientherapie.[5]  

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SOURCE GARFIELD-AF
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