Traditional thromboprophylaxis in elderlies with atrial fibrillation: What we can achieve in real life
| Autor: | T. Drobná, F. Németh, L. Gerlich, M. Dúbrava |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Economics and Econometrics
medicine.medical_specialty Administration Oral Atrial Fibrillation Materials Chemistry Media Technology medicine Humans In real life cardiovascular diseases Aged Aged 80 and over Geriatrics business.industry Warfarin Anticoagulants Forestry Mean age Atrial fibrillation Venous Thromboembolism medicine.disease Stroke Hospital admission Emergency medicine International normalised ratio Observational study business medicine.drug |
| Zdroj: | Bratislava Medical Journal. 120:764-768 |
| ISSN: | 1336-0345 |
| DOI: | 10.4149/bll_2019_127 |
| Popis: | OBJECTIVES To investigate real-world data on warfarinisation rates and results in the elderly patients with atrial fibrillation (AF). BACKGROUND AF is the most frequent arrhythmia in the elderlies with considerable risk of devastating stroke-related consequences. Guidelines prefer non-vitamin K antagonist oral anticoagulants (NOAC) to warfarin for thromboprophylaxis. Nevertheless, warfarin is still widely used, even if it is challenging, especially in polymorbid elderlies, to achieve the therapeutic international normalised ratio (INR). There are only scarce real-world data on INR in warfarinised elderly AF patients. METHODS The study was based on multicentric observational Slovak audit of atrial fibrillation in seniors (SAFIS) performed on 4,252 hospitalised AF patients aged over 64 years (mean age 80.9 yrs.). INR data from warfarinised patients were analysed (955 at admission and 870 at discharge). RESULTS At hospital admission and discharge, the warfarin medication rates were 22.6 % and 23.5 %, respectively, INR lower than 2 was present in 41.8 % and 30.6 % of patients, respectively, and INR higher than 3 was in 27.0 % and 7.7 %, respectively and altogether, 68.8 % and 38.3 % of warfarinised patients, respectively, were out of therapeutic range. CONCLUSION Warfarin is still frequently used in the elderlies with AF, but the success rates are unsatisfactory in a huge number of patients. It is urgent to improve seniors' access to NOAC (Fig. 2, Ref. 34). |
| Databáze: | OpenAIRE |
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