Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?

Yutao Guo1*, Qiang Wu2*, Lu Zhang1, Tingshu Yang1, Ping Zhu1, Wenqian Gao1, Yuexiang Zhao1, Meng Gao11Department of Geriatric Cardiology, 2Department of Clinical Administration, General Hospital of The Chinese PLA, Beijing, China; *Shared equal authorshipAbstract: Although attention has been given t...

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Autores principales:	Yutao Guo, Qiang Wu, Lu Zhang, et al
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	atrial fibrillation elderly antithrombotic therapy hemorrhage Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/8790235dd92e4815812236378d30dab4
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spelling	oai:doaj.org-article:8790235dd92e4815812236378d30dab42021-12-02T00:05:22ZAntithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?1178-1998https://doaj.org/article/8790235dd92e4815812236378d30dab42010-05-01T00:00:00Zhttps://www.dovepress.com/antithrombotic-therapy-in-very-elderly-patients-with-atrial-fibrillati-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yutao Guo1, Qiang Wu2, Lu Zhang1, Tingshu Yang1, Ping Zhu1, Wenqian Gao1, Yuexiang Zhao1, Meng Gao11Department of Geriatric Cardiology, 2Department of Clinical Administration, General Hospital of The Chinese PLA, Beijing, China; *Shared equal authorshipAbstract: Although attention has been given to thromboprophylaxis for atrial fibrillation (AF) in present treatment guidelines, practical, clinical antithrombotic therapy is poorly developed for very elderly patients. We reviewed the records of 105 consecutive patients with AF of mean age 85 years, to determine how the greatest benefits from antithrombotic therapy could be obtained in this group. The mean CHADS2 score in these patients was 3.1 ± 1.5. Before antithrombotic therapy, 21.0% of the patients had diseases with a risk of hemorrhage, 26.7% had diseases with a risk of thrombosis, and 8.6% had diseases with a risk of both hemorrhage and thrombosis. Moreover, 89 patients (84.8%) were receiving a single antiplatelet drug, 10 (9.5%) used aspirin plus clopidogrel, and six (5.7%) were taking an oral anticoagulant (OAC). Additionally, dual antiplatelet therapy was more commonly given to patients with permanent AF (paroxysmal and persistent versus permanent, 6.3% and 12.5% versus 30%, respectively, Chi-square = 8.4, P = 0.010). The incidence of adverse events was 25.7%, with thromboembolic events in 20.0% and hemorrhage in 5.7% of patients. There were no thromboembolic events in those patients taking OACs, but 33% of patients who took OACs had bleeding complications. It is difficult to choose appropriate antithrombotic strategies in very elderly patients. Both the thrombotic risk and the bleeding risk should be considered for helping such patients derive optimal benefit from thromboprophylaxis for AF.Keywords: atrial fibrillation, elderly, antithrombotic therapy, hemorrhageYutao GuoQiang WuLu Zhanget alDove Medical Pressarticleatrial fibrillationelderlyantithrombotic therapyhemorrhageGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 5, Pp 157-162 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation elderly antithrombotic therapy hemorrhage Geriatrics RC952-954.6
spellingShingle	atrial fibrillation elderly antithrombotic therapy hemorrhage Geriatrics RC952-954.6 Yutao Guo Qiang Wu Lu Zhang et al Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
description	Yutao Guo1, Qiang Wu2, Lu Zhang1, Tingshu Yang1, Ping Zhu1, Wenqian Gao1, Yuexiang Zhao1, Meng Gao11Department of Geriatric Cardiology, 2Department of Clinical Administration, General Hospital of The Chinese PLA, Beijing, China; *Shared equal authorshipAbstract: Although attention has been given to thromboprophylaxis for atrial fibrillation (AF) in present treatment guidelines, practical, clinical antithrombotic therapy is poorly developed for very elderly patients. We reviewed the records of 105 consecutive patients with AF of mean age 85 years, to determine how the greatest benefits from antithrombotic therapy could be obtained in this group. The mean CHADS2 score in these patients was 3.1 ± 1.5. Before antithrombotic therapy, 21.0% of the patients had diseases with a risk of hemorrhage, 26.7% had diseases with a risk of thrombosis, and 8.6% had diseases with a risk of both hemorrhage and thrombosis. Moreover, 89 patients (84.8%) were receiving a single antiplatelet drug, 10 (9.5%) used aspirin plus clopidogrel, and six (5.7%) were taking an oral anticoagulant (OAC). Additionally, dual antiplatelet therapy was more commonly given to patients with permanent AF (paroxysmal and persistent versus permanent, 6.3% and 12.5% versus 30%, respectively, Chi-square = 8.4, P = 0.010). The incidence of adverse events was 25.7%, with thromboembolic events in 20.0% and hemorrhage in 5.7% of patients. There were no thromboembolic events in those patients taking OACs, but 33% of patients who took OACs had bleeding complications. It is difficult to choose appropriate antithrombotic strategies in very elderly patients. Both the thrombotic risk and the bleeding risk should be considered for helping such patients derive optimal benefit from thromboprophylaxis for AF.Keywords: atrial fibrillation, elderly, antithrombotic therapy, hemorrhage
format	article
author	Yutao Guo Qiang Wu Lu Zhang et al
author_facet	Yutao Guo Qiang Wu Lu Zhang et al
author_sort	Yutao Guo
title	Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
title_short	Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
title_full	Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
title_fullStr	Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
title_full_unstemmed	Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?
title_sort	antithrombotic therapy in very elderly patients with atrial fibrillation: is it enough to assess thromboembolic risk?
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/8790235dd92e4815812236378d30dab4
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Antithrombotic therapy in very elderly patients with atrial fibrillation: Is it enough to assess thromboembolic risk?

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