Antithrombotic treatment and characteristics of elderly patients with non-valvular atrial fibrillation hospitalized at Internal Medicine departments. NONAVASC registry
Por:
Gullón A, Suárez C, Díez-Manglano J, Formiga F, Cepeda JM, Pose A, Camafort M, Castiella J, Rovira E and Mostaza JM
Publicada:
3 mar 2017
Ahead of Print:
16 dic 2016
Categoría:
Medicine (miscellaneous)
Resumen:
Background and objetives: The prevalence of non-valvular atrial fibrillation (NVAF) increases with the patient's age and is associated with high morbi-mortality rates. The main goal of this study was to describe the characteristics of hospitalized elderly patients with NVAF and to identify the clinical and functional factors which determine the use of different antithrombotic strategies.
Patients and methods: Observational, prospective, multicentre study carried out on patients with NVAF over the age of 75, who had been admitted for any medical condition to Internal Medicine departments.
Results: We evaluated 804 patients with a mean age of 85 years (range 75-101), of which 53.9% were females. The prevalence of risk factors and cardiovascular disease was high: hypertension (87.6%), heart failure (65.4%), ischemic cardiomyopathy (24.4%), cerebrovascular disease (22.4%) and chronic kidney disease (45%). Among those cases with previous diagnoses of NVAF, antithrombotic treatment was prescribed in 86.2% of patients: anticoagulants (59.7%), antiplatelet medication (17.8%) and double therapy (8.7%). The factors associated with the use of antithrombotic treatment were history of acute coronary syndrome and atrial fibrillation progression longer than one year. Older age, atrial-fibrillation for less than one year, higher HAS-BLED scores and severe cognitive impairment were associated with the use of anti-platelet drugs. Permanent atrial fibrillation favoured the use of anticoagulants.
Conclusions: Hospitalized patients older than 75 years old with NVAF showed numerous comorbidities. 'The percentage of anticoagulation was small and 18% received only anti-platelet therapy. The patient's age, atrial fibrillation's progression time and the severity of the cognitive impairment influenced this therapy choice. (C) 2016 Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Gullón A:
Servicio de Medicina Interna, Hospital Universitario de La Princesa. Madrid, España.
Suárez C:
Servicio de Medicina Interna, Hospital Universitario de La Princesa. Madrid, España
Díez-Manglano J:
Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España
Formiga F:
Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
:
Servicio de Medicina Interna, Hospital Vega Baja, Orihuela, Alicante. España
Pose A:
Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
Camafort M:
Servicio de Medicina Interna, Hospital Universitari Clínic Barcelona, Barcelona. España
Castiella J:
Servicio de Medicina Interna, Fundación Hospital Calahorra, Calahorra, La Rioja, España
:
Servicio de Medicina Interna, Hospital Universitario de la Ribera, Alzira, Valencia, España
Mostaza JM:
Servicio de Medicina Interna, Hospital Carlos III, Madrid, España
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