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Gegevens over één jaar van wereldwijd register voor atriumfibrillatie (AF) tonen dat antitrombosemiddelen niet optimaal worden gebruikt ter voorkoming van beroertes
Date:9/3/2013

s onderdeel van State of the Art: Acute coronary syndromes - current guidelines and future prospects (Acute coronaire syndromen – huidige richtlijnen en vooruitzichten voor de toekomst), een sessie waarin de vier hoogst gewaardeerde abstracten over dit onderwerp onder de aandacht werden gebracht. 

Hoogtepunten van de gegevens, die zijn gecorrigeerd voor relevante complicerende factoren, zijn onder meer:

Mondelinge presentatie

  • Aanzienlijk lager gebruik van VKA's onder AF-patiënten met acuut coronair syndroom (ACS) vergeleken met patiënten zonder ACS (48,9% vs. 51,7%, respectievelijk), ondanks een vergelijkbaar risico op overlijden door welke oorzaak dan ook, beroerte/systemische embolie (SE), ernstige bloeding en terugkerend ACS na 1 jaar
    • 10,1% (n=559) van de patiënten had een historie van ACS, en daarvan had 44,0% (n=246) een historie van stentbehandeling

Posterpresentaties

  • Hoger risicoprofiel en meer frequent gebruik van antitrombosetherapie onder AF-patiënten die eerder een beroerte of een TIA (Transient Ischaemic Attack) hebben gehad 
    • AF-patiënten met een eerdere beroerte/TIA hadden een 44% groter risico op overlijden (HR* 1,44, p=0,037) en een meer dan twee keer zo grote kans op een beroerte/SE (HR 2,27, p=0,004) binnen het eerste jaar na de diagnose dan patiënten die nog geen beroerte/TIA hadden gehad
    • Meer AF-patiënten met een eerdere beroerte/TIA kregen VKA's (58,1% vs. 50,5% voor patiënten zonder eerdere beroerte/TIA), hoewel deze anticoagulantia duidelijk onvoldoende werden toegepast in beide groepen
  • Lager risico op overlijden voor AF-patiënten die werden behandeld met ritmecontrole (het gebruik van medicatie om
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SOURCE Thrombosis Research Institute
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