Abstract：
BACKGROUND: The global burden of cardiovascular disease (CVD) is forecast to increase, and anticoagulants will remain important medicines for its management. Coroners\' Prevention of Future Death reports (PFDs) provide valuable insights that may enable safer and more effective use of these agents.
OBJECTIVE: To identify CVD-related PFDs involving anticoagulants.
METHODS: Retrospective observational study of coronial case reports in England and Wales between 2013 and 2019.
METHODS: We screened 3037 PFDs for eligibility and included PFDs where CVD and an anticoagulant caused or contributed to the death. We descriptively analysed included cases and used content analysis to assess concerns raised by coroners and who responded to them.
RESULTS: We identified 113 cardiovascular disease-related PFDs involving anticoagulants. Warfarin (36%), enoxaparin (11%), and rivaroxaban (11%) were the most common anticoagulants reported. Concerns most frequently raised by coroners included poor systems (31%), poor communication (25%), and failures to keep accurate medical records (25%). These concerns were most often directed to NHS trusts (29%), hospitals (10%), and general practices (8%). Nearly two-thirds (60%) of PFDs had not received responses from such organisations, which are mandatory under regulation 28 of the Coroners\' (Investigations). We created a publicly available tool, https://preventabledeathstracker.net/, which displays coroners\' reports in England and Wales to streamline access and identify important lessons to prevent future deaths.
CONCLUSIONS: National organisations, healthcare professionals, and prescribers should take actions to address the concerns of coroners\' in PFDs to improve the safe use of anticoagulants in patients with cardiovascular disease.
OBJECTIVE: To identify CVD-related PFDs involving anticoagulants.
METHODS: Retrospective observational study of coronial case reports in England and Wales between 2013 and 2019.
METHODS: We screened 3037 PFDs for eligibility and included PFDs where CVD and an anticoagulant caused or contributed to the death. We descriptively analysed included cases and used content analysis to assess concerns raised by coroners and who responded to them.
RESULTS: We identified 113 cardiovascular disease-related PFDs involving anticoagulants. Warfarin (36%), enoxaparin (11%), and rivaroxaban (11%) were the most common anticoagulants reported. Concerns most frequently raised by coroners included poor systems (31%), poor communication (25%), and failures to keep accurate medical records (25%). These concerns were most often directed to NHS trusts (29%), hospitals (10%), and general practices (8%). Nearly two-thirds (60%) of PFDs had not received responses from such organisations, which are mandatory under regulation 28 of the Coroners\' (Investigations). We created a publicly available tool, https://preventabledeathstracker.net/, which displays coroners\' reports in England and Wales to streamline access and identify important lessons to prevent future deaths.
CONCLUSIONS: National organisations, healthcare professionals, and prescribers should take actions to address the concerns of coroners\' in PFDs to improve the safe use of anticoagulants in patients with cardiovascular disease.
摘要：
背景：心血管疾病（CVD）的全球负担预计将增加，抗凝剂仍将是其管理的重要药物。验尸官“预防未来死亡报告”（PFD）提供了有价值的见解，可以更安全，更有效地使用这些药物。
目的：鉴定涉及抗凝血剂的CVD相关PFDs。
方法：对2013年至2019年英格兰和威尔士的冠状病例报告进行回顾性观察研究。
方法：我们筛选了3037个PFD的合格性，并纳入了CVD和抗凝剂引起或促成死亡的PFD。我们对纳入的病例进行了描述性分析，并使用内容分析来评估验尸官提出的问题以及对这些问题的回应。
结果：我们确定了113种涉及抗凝剂的心血管疾病相关PFD。华法林（36%），依诺肝素（11%），利伐沙班(11%)是最常见的抗凝剂.验尸官最常提出的担忧包括系统不佳(31%)，沟通不良（25%），和未能保持准确的医疗记录（25％）。这些担忧最常见的是针对NHS信托(29%)，医院（10%），和一般做法(8%)。近三分之二（60％）的PFD没有收到此类组织的答复，根据验尸官第28条(调查)，这是强制性的。我们创建了一个公开可用的工具，https://preventabledeathstracker.net/,它显示了英格兰和威尔士的验尸官报告，以简化访问并确定重要的教训，以防止未来的死亡。
结论：国家组织，医疗保健专业人员,处方医师应采取行动解决PFD中验尸官的担忧,以提高心血管疾病患者抗凝药的安全使用.
目的：鉴定涉及抗凝血剂的CVD相关PFDs。
方法：对2013年至2019年英格兰和威尔士的冠状病例报告进行回顾性观察研究。
方法：我们筛选了3037个PFD的合格性，并纳入了CVD和抗凝剂引起或促成死亡的PFD。我们对纳入的病例进行了描述性分析，并使用内容分析来评估验尸官提出的问题以及对这些问题的回应。
结果：我们确定了113种涉及抗凝剂的心血管疾病相关PFD。华法林（36%），依诺肝素（11%），利伐沙班(11%)是最常见的抗凝剂.验尸官最常提出的担忧包括系统不佳(31%)，沟通不良（25%），和未能保持准确的医疗记录（25％）。这些担忧最常见的是针对NHS信托(29%)，医院（10%），和一般做法(8%)。近三分之二（60％）的PFD没有收到此类组织的答复，根据验尸官第28条(调查)，这是强制性的。我们创建了一个公开可用的工具，https://preventabledeathstracker.net/,它显示了英格兰和威尔士的验尸官报告，以简化访问并确定重要的教训，以防止未来的死亡。
结论：国家组织，医疗保健专业人员,处方医师应采取行动解决PFD中验尸官的担忧,以提高心血管疾病患者抗凝药的安全使用.
