Optimal Antithrombotic Therapy in Atrial Fibrillation;Final Progress rept. 1 Jul 99-30 Jun 03

摘要

The goals were to determine the outcomes of antithrombotic therapy in Medicare beneficiaries who have atrail fibrillation (AF) and to increase the use of antithrombotic therapy in this population. The 2.1 million Medicare beneficiaries with AF have a five-fold increased risk of stroke. Antithrombotic therapy reduces this risk, but impairs quality of life and can cause bleeding. The authors combined medical chart review data collected by Quality Improvement Organizations representing 7 states with 3 years of Medicare part A claims data to form the National Registry of AF. The authors used the dataset to quantify the risks of stroke and hemorrhage and to form clinical prediction rules for these adverse events. The authors did two randomized controlled trials to evaluate the optimal-method of managing warfarin therapy, and two decision analyses to evaluation the cost effectiveness of antithrombotic therapy.