目的：分析房颤患者持续时间小于48小时急诊复律前是否抗凝与血栓栓塞风险评估。方法：回顾性分析2013年1月至2018年12月急诊就诊于内蒙古医科大学附属医院急诊科的房颤复律患者，观察出院后血栓栓塞事件。结果：房颤持续时间小于48小时者复律后出院共473例，277例复律前未接受抗凝治疗，196例复律前接受抗凝治疗。复律后随访0-360天，和抗凝组比较，未抗凝组血栓栓塞风险HR为1.45 (95% CI： 1.21–1.72)；和药物复律比较，电复律的血栓栓塞风险HR为1.61 (95% CI： 1.22–2.15)。HR值在CHA2DS2-VASc评分=1和CHA2DS2-VASc评分≥2分别为1.57（95% CI： 0.81–3.01 ） 和 4.61（95% CI：2.71–8.15）。结论：CHA2DS2-VASc评分≥1的房颤患者持续时间小于48小时复律前抗凝在降低血栓栓塞风险方面可能获益。

OBJECTIVE: To investigate if thromboembolism in association with cardioversion of atrial fibrillation differed between patients with and without anticoagulant therapy prior when it performed within 48h after onset.METHODS: Retrospective study of patients with atrial fibrillation undergoing cardioversion from The Affiliated Hospital Of Inner Mongolia Medical University from January 1st 2013 until December 31st 2018. Main outcome measures were thromboembolism .The risk of thromboembolism was estimated by calculating incidence rates and by multivariable adjusted Cox proportional-hazard models.RESULTS:In total 473 atrial fibrillation patients underwent cardioversion discharged, 196 with and 277 without anticoagulant therapy pre-treatment. Patients with no anticoagulant therapy the hazard ratio (HR) was 1.45 95% confidence interval (CI), 1.21–1.72 compared with patients with anticoagulant therapy. The HR in patients with no anticoagulant therapy was 1.57（95% CI： 0.81–3.01 ） and 4.61（95% CI：2.71–8.15） within 0–360 days with CHA2DS2-VASc score 1 and CHA2DS2-VASc score 2 or more, respectively. Also, patients with Electrical CThe results suggest that cardioversion of AF with less than 48-hour duration without prior anticoagulation may be safe for patients with risk factors for thromboembolism (CHA2DS2-VASc score ≥1 point).ardioversion the hazard ratio (HR) was 1.74; 95% confidence interval (CI), 1.72–2.51 compared with patients with Pharmacological Cardioversion.CONCLUSION:

内蒙古医科大学青年创新基金，项目编号：YKD2014QNCX023