MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN HUYẾT KHỐI ĐỘNG MẠCH HỆ THỐNG Ở BỆNH NHÂN RUNG NHĨ KHÔNG DO BỆNH VAN TIM ĐƯỢC ĐIỀU TRỊ THUỐC KHÁNG ĐÔNG TÁC DỤNG TRỰC TIẾP ĐƯỜNG UỐNG

Abstract

Objectives: To determine the incidence and factors associated with systemic arterial thromboembolism in patients with non-valvular atrial fibrillation receiving direct oral anticoagulant (DOAC) therapy. Methods: A retrospective, prospective cohort study was conducted on 182 patients with non-valvular atrial fibrillation treated with DOACs at People's Hospital 115 from December 2023 to June 2025. Patients were followed for 12 months. The primary outcome was systemic arterial thromboembolism. Multivariable logistic regression analysis was performed to identify independent associated factors. Results: The median age was 77 years (IQR: 68 - 84), and 54.4% of patients were female. The incidence of systemic arterial thromboembolism was 4.9% during follow-up. In multivariable analysis, age ≥ 85 years (OR = 16.27, 95%CI: 2.92 - 90.61; p = 0.001) and prior ischemic stroke (OR = 6.53, 95%CI: 1.32 - 32.36; p = 0.022) were independently associated with systemic arterial thromboembolism. Conclusion: Despite DOAC therapy, patients with non-valvular atrial fibrillation remain at a considerable risk of systemic arterial thromboembolism. Identification of high-risk subgroups, particularly those with very advanced age and a history of ischemic stroke, requires closer monitoring in clinical practice.