Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study

Wei Xiang, Jingwei Zhang, Meilin Liu, Fang Liu, Xueru Feng, Yuchuan Wang Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China Objective: Non-valvular atrial fibrillation (NVAF) is one common arrhythmia in the elderly. However, use of antithrombo...

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Autores principales:	Xiang W, Zhang JW, Liu ML, Liu F, Feng XR, Wang YC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Elderly Atrial fibrillation Ischemic stroke Anticoagulation CHA2DS2–VASc score Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f055d10c9d0f4c188fa29d4af96d3eb5
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spelling	oai:doaj.org-article:f055d10c9d0f4c188fa29d4af96d3eb52021-12-02T06:04:14ZAntithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study1178-1998https://doaj.org/article/f055d10c9d0f4c188fa29d4af96d3eb52015-03-01T00:00:00Zhttps://www.dovepress.com/antithrombotic-therapy-in-elderly-patients-with-non-valvular-atrial-fi-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Wei Xiang, Jingwei Zhang, Meilin Liu, Fang Liu, Xueru Feng, Yuchuan Wang Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China Objective: Non-valvular atrial fibrillation (NVAF) is one common arrhythmia in the elderly. However, use of antithrombotic therapy in this population is not well known in the People’s Republic of China. This study aimed at investigating antithrombotic therapy status in elderly patients with NVAF in our hospital.Methods: A cross-sectional study of consecutive geriatric patients aged ≥60 years with NVAF who discharged from our hospital between January 2012 and December 2013 were collected. CHA2DS2-VASc score (cardiac failure or dysfunction, hypertension, age ≥75 [doubled], diabetes, stroke or transient ischemic attack [doubled], vascular disease, age 65–74, and sex category [female]) was used to analyze antithrombotic indication.Results: We consecutively collected data of 1,000 discharged elderly patients (≥60 years) with NVAF (mean age 75.3±8.0 years, 75 years or older 54.7%, female 42.7%). The proportion of paroxysmal atrial fibrillation and non-paroxysmal atrial fibrillation (persistent or permanent) patients were 39.4% and 60.6%, respectively. Among 1,000 patients, 29.1% received oral anticoagulant therapy (OAT), including warfarin (27.8%) and novel oral anticoagulants (1.3%), 39.5% of patients received antiplatelet therapy, and 31.4% received neither therapy. Based on CHA2DS2-VASc score for stroke risk stratification, 68.9% patients with score ≥1 and 70.2% patients with score ≥2 received antithrombotic therapy, while the rates of OAT were 29.1% and 29.5%, respectively. Among patients with high stroke risk, those with paroxysmal atrial fibrillation were less likely to receive OAT compared with the patients with non-paroxysmal atrial fibrillation (19.5% vs 35.7%, P<0.001). The patients ≥75 years old had lower rate of OAT than the patients <75 years old (25.8% vs 34.8%, P=0.003). The patients with coronary artery disease had lower rate of OAT than the patients without coronary artery disease (24.4% vs 33.4%, P=0.003). Sex and history of stroke or transient ischemic attack had no effect on the use of OAT (30.8% vs 27.9%, P=0.326 and 28.8% vs 29.8%, P=0.761, respectively).Conclusion: OAT in elderly patients with NVAF in our hospital is underused, especially in those patients with higher risk of stroke. Keywords: elderly, atrial fibrillation, ischemic stroke, anticoagulation, CHA2DS2-VASc scoreXiang WZhang JWLiu MLLiu FFeng XRWang YCDove Medical PressarticleElderlyAtrial fibrillationIschemic strokeAnticoagulationCHA2DS2–VASc scoreGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 515-519 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Elderly Atrial fibrillation Ischemic stroke Anticoagulation CHA2DS2–VASc score Geriatrics RC952-954.6
spellingShingle	Elderly Atrial fibrillation Ischemic stroke Anticoagulation CHA2DS2–VASc score Geriatrics RC952-954.6 Xiang W Zhang JW Liu ML Liu F Feng XR Wang YC Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
description	Wei Xiang, Jingwei Zhang, Meilin Liu, Fang Liu, Xueru Feng, Yuchuan Wang Department of Geriatrics, Peking University First Hospital, Beijing, People’s Republic of China Objective: Non-valvular atrial fibrillation (NVAF) is one common arrhythmia in the elderly. However, use of antithrombotic therapy in this population is not well known in the People’s Republic of China. This study aimed at investigating antithrombotic therapy status in elderly patients with NVAF in our hospital.Methods: A cross-sectional study of consecutive geriatric patients aged ≥60 years with NVAF who discharged from our hospital between January 2012 and December 2013 were collected. CHA2DS2-VASc score (cardiac failure or dysfunction, hypertension, age ≥75 [doubled], diabetes, stroke or transient ischemic attack [doubled], vascular disease, age 65–74, and sex category [female]) was used to analyze antithrombotic indication.Results: We consecutively collected data of 1,000 discharged elderly patients (≥60 years) with NVAF (mean age 75.3±8.0 years, 75 years or older 54.7%, female 42.7%). The proportion of paroxysmal atrial fibrillation and non-paroxysmal atrial fibrillation (persistent or permanent) patients were 39.4% and 60.6%, respectively. Among 1,000 patients, 29.1% received oral anticoagulant therapy (OAT), including warfarin (27.8%) and novel oral anticoagulants (1.3%), 39.5% of patients received antiplatelet therapy, and 31.4% received neither therapy. Based on CHA2DS2-VASc score for stroke risk stratification, 68.9% patients with score ≥1 and 70.2% patients with score ≥2 received antithrombotic therapy, while the rates of OAT were 29.1% and 29.5%, respectively. Among patients with high stroke risk, those with paroxysmal atrial fibrillation were less likely to receive OAT compared with the patients with non-paroxysmal atrial fibrillation (19.5% vs 35.7%, P<0.001). The patients ≥75 years old had lower rate of OAT than the patients <75 years old (25.8% vs 34.8%, P=0.003). The patients with coronary artery disease had lower rate of OAT than the patients without coronary artery disease (24.4% vs 33.4%, P=0.003). Sex and history of stroke or transient ischemic attack had no effect on the use of OAT (30.8% vs 27.9%, P=0.326 and 28.8% vs 29.8%, P=0.761, respectively).Conclusion: OAT in elderly patients with NVAF in our hospital is underused, especially in those patients with higher risk of stroke. Keywords: elderly, atrial fibrillation, ischemic stroke, anticoagulation, CHA2DS2-VASc score
format	article
author	Xiang W Zhang JW Liu ML Liu F Feng XR Wang YC
author_facet	Xiang W Zhang JW Liu ML Liu F Feng XR Wang YC
author_sort	Xiang W
title	Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
title_short	Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
title_full	Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
title_fullStr	Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
title_full_unstemmed	Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
title_sort	antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/f055d10c9d0f4c188fa29d4af96d3eb5
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Antithrombotic therapy in elderly patients with non-valvular atrial fibrillation: a pilot study

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