Impact of attack frequency and therapy strategies on outcome of patients with vasovagal syncope / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope (VVS).</p><p><b>METHODS</b>A total of 159 patients (aged from 15 - 59 years old) with VVS were included in this study. Patients were divided into low frequency (< 3) group (n = 95) and high (≥ 3) frequency group (n = 64) according to the attack frequency in the past 5 years at the primary survey. Patients received one of the three therapies: no treatment, physical therapy, and comprehensive treatment. All cases were followed up with telephone or outpatient visit for 24 months.</p><p><b>RESULTS</b>Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40.6% (26/64) vs. 11.6% (11/95), P < 0.01]. The overall improvement rate was significantly higher in the low frequency group than that of high frequency group (P < 0.01). Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [81.8% (27/33) vs. 47.1% (8/17), P < 0.05; 82.2% (37/45) vs. 47.1% (8/17), P < 0.05], and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [62.2% (28/45) vs. 31.6% (6/19), P < 0.05] for patients with high attack frequency.</p><p><b>CONCLUSION</b>Outcome is related to previous attack frequency for patients with VVS, physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.</p>

Comparative study of warfarin and aspirin for stroke prevention in elderly patients with atrial fibrillation / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze current stroke prevention measures for elderly patients with atrial fibrillation.</p><p><b>METHODS</b>A retrospective analysis was conducted of the clinical records of elderly patients with atrial fibrillation treated in our hospital within the recent 5 years. The distribution of high risk factors for different age levels was studied, and the incidence of stroke and complications such as hemorrhage were compared between patients treated with warfarin and aspirin therapy.</p><p><b>RESULTS</b>Compared with patients of 65 to 75 years old, the incidence of complications with other high risk factors was increased in advanced age group (over 75 years). Of these patients, 19.0% were treated with warfarin and 73.4% with aspirin. Compared with the aspirin group, stroke incidence was decreased significantly in warfarin group, which had simultaneously increased nonfatal hemorrhage.</p><p><b>CONCLUSION</b>Warfarin can be more effective than aspirin for stroke prevention in elderly patients with atrial fibrillation, but in clinical practice, the usage rate of warfarin still remains low with insufficient monitoring.</p>