Clinical profile and outcomes in octogenarians with atrial fibrillation: A community-based study in a specific European health care area
| Autor: | Alfonso Varela-Román, Ricardo Laje, Carlos Peña-Gil, Estrella López-Pardo, José Ramón González-Juanatey, Pilar Mazón, Jose-Luis Martínez-Sande, Alberto Cordero, Alvaro Martínez-Gomez, María Pereira-Vázquez, José Novo-Platas, Moisés Rodríguez-Mañero, Javier García-Seara, José María García-Acuña, Isabel Moscoso, Omar Kredieh |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent 030204 cardiovascular system & hematology Young Adult 03 medical and health sciences 0302 clinical medicine Median follow-up Octogenarian Internal medicine Atrial Fibrillation medicine Electronic Health Records Humans Dementia Community Health Services 030212 general & internal medicine Young adult Stroke Aged Aged 80 and over business.industry Mortality rate Atrial fibrillation Middle Aged medicine.disease Europe Clinical trial Treatment Outcome Spain Heart failure Physical therapy Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | INTERNATIONAL JOURNAL OF CARDIOLOGY r-FISABIO. Repositorio Institucional de Producción Científica INIA: Repositorio de Resultados de Investigación del INIA r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| ISSN: | 0167-5273 |
| Popis: | Background: Age increases risk of stroke and bleeding. Clinical trial data have had relatively low proportions of elderly subjects. We sought to study a Spanish population of octogenarians with atrial fibrillation (AF) by combining different sources of electronic clinical records from an area where all medical centres utilized electronic health record systems. Methods: Data was derived from the Galician Healthcare Service information system. Results: From 383,000 subjects, AF was coded in 7990 (2.08%), 3640 (45.6%) of whom were >= 80 and 4350 (54.4%) = 80, 2178 (59.8%) were women. Mean CHA(2)DS(2)-VASc was 4.2 +/- 1.1. Distribution of CHA(2)DS(2)-VASc components varied between genders. 2600 (71.4%) were on oral anticoagulant (OA). During a median follow up of 696 days (124.23), all-cause mortality was higher in >= 80 (1011/3640 (27.8%) vs 350/4350 (8.05%) (p < 0.001). There were differences in rate of thromboembolic (TE) and haemorrhagic events (2.3% vs 0.9%, p < 0.01 and 2.5% vs 1.7%, p = 0.01 respectively). In octogenarian, differences between genders were observed with regard to TE, but not in haemorrhagic or all-cause mortality rates. Age, heart failure, non-valvular AF, dementia, and OA were independent predictors of all-cause mortality. In regard to TE, female gender, hypertension, previous TE and OA were independent predictive factors. Conclusions: Octogenarians with AF had very different characteristics and outcomes from their younger counterparts. These results also provide reassurance about the effectiveness of OA in preventing TE events and maintaining a reasonable haemorrhagic event rate in the extremely elderly. (C) 2017 Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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