1、房颤房颤-流行病与医疗费用流行病与医疗费用首都医科大学附属北京安贞医院首都医科大学附属北京安贞医院 马长生马长生 2021/3/7房颤的患病率房颤的患病率(ATRIA 研究研究)JAMA 2001;23702021/3/7不同研究中房颤的患病率不同研究中房颤的患病率J Cardiovasc Nurs 2004;942021/3/7房颤患者的住院率房颤患者的住院率Circulation 2003;7112021/3/7美国房颤患病率的发展趋势美国房颤患病率的发展趋势JAMA 2001;23702021/3/7中国房颤的发病率中国房颤的发病率Int J Cardiol 2005;2832021/3
2、/7中国中国-房颤的患病率房颤的患病率 Crude prevalence 0.77%Age-standardized prevalence 0.65%male 0.66%;female 0.63%J Epidemiol 2008;2092021/3/7中国中国-房颤患者的年龄构成房颤患者的年龄构成Int J Cardiol 2005;2832021/3/7中国中国-房颤的病因以及相关发病因素房颤的病因以及相关发病因素Int J Cardiol 2005;2832021/3/7中国中国-非瓣膜病房颤患者脑卒中发病率非瓣膜病房颤患者脑卒中发病率Chin J Cardiol 2002;165Inci
3、dence of Stroke(/year)%2021/3/7中国中国-房颤房颤/非房颤患者脑卒中的患病率非房颤患者脑卒中的患病率Stroke Stroke(n)(n)Non-stroke Non-stroke (n)(n)Total Total subjects(n)subjects(n)Prevalence of Prevalence of stroke(%)stroke(%)AFAF292919519522422412.9512.95Non-AFNon-AF657657281732817328855288552.282.28SumSum68668628368283682907929079
4、2.362.36J Epidemiol 2008;2092021/3/7房颤患者的抗栓治疗和脑卒中发生率房颤患者的抗栓治疗和脑卒中发生率Treatment Group Treatment Group PatientsPatientsPatients with Patients with strokestrokeRate of Rate of stroke(%)stroke(%)AntiplateletAntiplatelet499149913343346.76.7AnticoagulantAnticoagulant57257232325.55.5No antithromboticNo anti
5、thrombotic3062306274174124.224.2Int J Cardiol 2005;2832021/3/7中国当前房颤的治疗情况中国当前房颤的治疗情况Anticoagulation(%)Ablation(10,000)2021/3/7房颤年度医疗花费的构成房颤年度医疗花费的构成Europace 2008;4032021/3/7不同因素对房颤治疗价不同因素对房颤治疗价/效关系的影响效关系的影响Pharmacoeconomics 2000;3172021/3/7房颤导管消融与药物治疗医疗费用的比较房颤导管消融与药物治疗医疗费用的比较PACE 2003;2922021/3/7USU
6、K不同国家房颤医疗费用的构成不同国家房颤医疗费用的构成2021/3/7Am Heart J 2004;121房颤医疗费用的构成房颤医疗费用的构成2021/3/7房颤消融前后对医疗资源占用的比较房颤消融前后对医疗资源占用的比较JICE 2003;59 2021/3/7J Cardiovasc Electrophysiol 2008;Epub房颤导管消融与药物治疗费用的比较房颤导管消融与药物治疗费用的比较2021/3/7 Preablation examinations:CT、TEE、TTE、biochemical test Catheter ablation：Abl catheter、Refer
7、ence pad、Lasso catheter Postablation medication Warfarin、Amiodarone 中国中国-导管消融的费用导管消融的费用Total cost:60,000-80,000 RMB 2021/3/7Thank you!2021/3/72021/3/7Atrial fibrillationAtrial fibrillation：The Epidemic and CostThe Epidemic and CostChangsheng Ma,M.D.Department of CardiologyBeijing Anzhen Hospital,Cap
8、ital Medical University Beijing,P.R.China Dem 13,2008 2021/3/7Prevalence of Diagnosed AF(ATRIA study)JAMA 2001;23702021/3/7Prevalence of AF in population-based studiesJ Cardiovasc Nurs 2004;942021/3/7Prevalence of hospitalizations for AFCirculation 2003;7112021/3/7Projected Number of AF in U.SJAMA 2
9、001;23702021/3/7Incidence of AF in ChinaInt J Cardiol 2005;2832021/3/7Prevalence of AF in China Crude prevalence 0.77%Age-standardized prevalence 0.65%male 0.66%;female 0.63%J Epidemiol 2008;2092021/3/7Age distribution of patients with AFInt J Cardiol 2005;2832021/3/7Causes and associated factors fo
10、r AFInt J Cardiol 2005;2832021/3/7Incidence of Stroke in patients with NVAFChin J Cardiol 2002;165Incidence of Stroke(/year)%2021/3/7Prevalence of stroke in AF/non-AF cohortsStroke Stroke(n)(n)Non-stroke Non-stroke (n)(n)Total Total subjects(n)subjects(n)Prevalence of Prevalence of stroke(%)stroke(%
11、)AFAF292919519522422412.9512.95Non-AFNon-AF657657281732817328855288552.282.28SumSum686686283682836829079290792.362.36J Epidemiol 2008;2092021/3/7Antithrombotic treatment and stroke rate in AFTreatment Group Treatment Group PatientsPatientsPatients with Patients with strokestrokeRate of Rate of strok
12、e(%)stroke(%)AntiplateletAntiplatelet499149913343346.76.7AnticoagulantAnticoagulant57257232325.55.5No antithromboticNo antithrombotic3062306274174124.224.2Int J Cardiol 2005;2832021/3/7Current treatment of AF in ChinaAnticoagulation(%)Ablation(10,000)2021/3/7Distribution of annual costs of AFEuropac
13、e 2008;4032021/3/7Influence of variables on cost/effectiveness of AF therapyPharmacoeconomics 2000;3172021/3/7Costs of Ablation vs Medication of AFPACE 2003;2922021/3/7USUKDistribution of costs of care in AF2021/3/7Distribution of costs of care in AF in the societal perspectiveAm Heart J 2004;121202
14、1/3/7Comparison of healthcare resource utilization before and after ablationJICE 2003;59 2021/3/7J Cardiovasc Electrophysiol 2008;EpubCosts of Ablation vs Medication of AF2021/3/7 Preablation examinations:CT、TEE、TTE、biochemical test Catheter ablation：Abl catheter、Reference pad、Lasso catheter Postablation medication Warfarin、Amiodarone Costs of AF Catheter ablation in ChinaTotal cost:60,000-80,000 RMB 2021/3/7Thank you!2021/3/72021/3/746
