Oral anticoagulation in octogenarians with atrial fibrillation.

Autor: Hugo GS; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Figueiras-Graillet LM; Facultad de Medicina Campus Xalapa. Universidad Veracruzana, Xalapa, Veracruz, Mexico., Anguita M; Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain., Marín F; Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain., Bertomeu V; Department of Cardiology, Hospital San Juan de Alicante, Spain., Roldán I; Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain., Ruiz M; Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain., Muñiz J; Instituto Universitario de Ciencias de la Salud e INIBIC, Universidad de A Coruña, Spain., Martínez-Sellés M; Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Universidad Complutense, Madrid, Spain; Universidad Europea, Madrid, Spain. Electronic address: mmselles@secardiologia.es.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2016 Nov 15; Vol. 223, pp. 87-90. Date of Electronic Publication: 2016 Aug 04.
DOI: 10.1016/j.ijcard.2016.08.004
Abstrakt: Background: Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial fibrillation (AF). Our aim was to study the clinical profile of octogenarians treated with oral anticoagulation and to study the effect of age on the quality of VKAs anticoagulation.
Methods: Data are from a prospective national registry in an adult Spanish population of nonvalvular AF. We included 1637 patients who had been receiving VKAs for at least 6months before enrolment.
Results: Mean age was 73.8±9.4years. Patients aged >80years (N=429) had a high risk profile with higher risk of stroke and bleeding than younger patients; CHA 2 DS 2 -VASc (Cardiac failure, Hypertension, Age>74, Diabetes, Stroke, Vascular disease, Age 65-74years, and Sex category) 4.5±1.3 vs. 3.5±1.6, p<0.001, HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (>64years), Drugs/alcohol concomitantly) 2.4±0.9 vs. 1.9±1.1, p<0.001. Creatinine clearance was lower in octogenarians than in younger patients (54.3±16.1ml/min vs. 69.5±23.7ml/min, p<0.001) and severe renal disease with creatinine clearance <30ml/min was more frequent in octogenarians (5.2% vs. 2.2%, p<0.001). In patients treated with VKAs (N=1637), the international normalized ratio values of the 6months previous to enrollment were similar in all age quartiles, as was the time in the therapeutic range.
Conclusion: In this large registry octogenarians with nonvalvular AF had high risk of stroke and bleeding and frequent renal disease. VKAs anticoagulation quality was similar in octogenarians and in younger patients.
(Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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