A trial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide. In 2008, the estimated agestandardized AF prevalence in China was 0.65%, suggesting that at least 4 million adults had AF, 1 and it was predicted that 5.2 million men and 3.1 million women aged >60 years will be affected by AF in China by 2050. 2AF increases the risk of stroke, and AF-related stroke is more fatal and disabling, compared with non-AF stroke.3 Oral anticoagulation (OAC) is recommended to reduce the risk of thromboembolic events in patients with AF with either a moderate or high risk of stroke. 4,5 Various registry studies report that nearly half to four fifths of high-risk AF patients were taking OAC therapy in developed countries 6-10 ; however, in Chinese patients with AF, OAC remains underused. 11During the past decade, the Chinese medical societies have made great efforts to improve stroke prevention among Background and Purpose-Reported rates of oral anticoagulation (OAC) use have been low among Chinese patients with atrial fibrillation (AF). With improved awareness, changing guidelines, this situation may be changing over time. We aimed to explore the current status and time trends of OAC use in Beijing. Methods-We used the data set from the Chinese Atrial Fibrillation Registry (CAFR), a prospective, multicenter, hospitalbased registry study involving 20 tertiary and 12 nontertiary hospitals in Beijing. A total of 11 496 patients with AF were enrolled from 2011 to 2014. Results-Seven thousand nine hundred seventy-seven eligible patients were included in this ancillary study.
Corticosteroids play an important role in the clinical management of threatened preterm delivery between 24 and 34 weeks of gestational age. It is known that corticosteroids have a direct, transient effect on fetal heart rate (fHR) parameters. Fetal heart rate variability is a reflection of autonomic nervous system activity and a useful marker for fetal well-being. Therefore, it is important to interpret the changes that occur in fHR parameters during corticosteroid treatment correctly, to avoid unnecessary iatrogenic preterm delivery. We performed a systematic review of the literature in CENTRAL, PubMed, and EMBASE, including 15 articles. In this review, we discuss the influence of corticosteroids on fHR parameters, in particular fHR variability, and fetal behavior. Furthermore, we explain possible mechanisms of action and confounding factors.
BackgroundRobust data on the contemporary management of atrial fibrillation (AF) patients in China are limited. Importantly current practice in AF management has changing dramatically in recent years. Data from a large registry study will enable us to evaluate the uptake and outcomes with different therapies in a large Chinese AF population.Methods/DesignThe Chinese Atrial Fibrillation Registry study (CAFR) aims to enroll 20,000 consecutive atrial fibrillation (AF) patients from 32 tertiary and non-tertiary hospitals in Beijing, China, and follow up these patients every 6 months until 2020. Key data collected includes basic sociodemographic information, symptoms and signs, medical history, results of physical examination and laboratory test, details of treatments and personal insurance status. For patients who consent, 5 ml of blood sample will be stored at −80 °C for future analyses of biomarkers. At each 6 month follow up visit, data relating to clinical outcomes will be collected. Data from a randomly selected 10 % of patients will be internally validated with their raw source data. Ischemic stroke events will be adjudicated by an independent endpoint committee.DiscussionCAFR will be one of the largest registries of Asian AF patients (and the largest in Chinese AF patients), as well as providing the longest follow up. This study would provide a valuable opportunity for ‘real world’ clinical epidemiology with insights into the uptake (and outcomes) of contemporary AF management.Trial registrationChinese Clinical Trial Registry ChiCTR-OCH-13003729. Registered 22 October 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0308-1) contains supplementary material, which is available to authorized users.
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