PMID- 32702889
OWN - NLM
STAT- MEDLINE
DCOM- 20200803
LR  - 20210317
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 99
IP  - 29
DP  - 2020 Jul 17
TI  - Stroke prevention and guideline adherent antithrombotic treatment in elderly 
      patients with atrial fibrillation: A real-world experience.
PG  - e21209
LID - 10.1097/MD.0000000000021209 [doi]
LID - e21209
AB  - Patients aged >/=75 years with the diagnosis of atrial fibrillation (AF) are at a 
      higher risk of stroke and, according to recent recommendations, should receive 
      oral anticoagulant (OAC) therapy. This study aimed to assess the recommended 
      prophylactic antithrombotic therapy among patients with AF aged >/= 75 years and 
      its compliance with current guidelines. We also aimed to identify predisposing 
      factors associated with the administration of non-vitamin K antagonist oral 
      anticoagulants (NOACs) in elderly patients with AF.This was a retrospective, 
      single-center observational study. Patients with AF aged >/=75 years hospitalized 
      at a reference cardiology center from 2014 to 2017 were included in the 
      analysis.Among the 1236 eligible patients (43.4% male; mean age, 82 years), OACs 
      were recommended in 90.1% of cases. Of these, 59.8% of patients used NOACs and 
      40.2% used vitamin K antagonists. Additionally, 3.3% of patients received 
      antiplatelet (AP) therapy and 2.5% were administered low molecular weight 
      heparin. Only 4.5% of patients did not receive any anticoagulant treatment. The 
      majority (89.9%) of patients received relevant prophylactic antithrombotic 
      therapy according to current guidelines; only 1.4% were overtreated and 8.7% were 
      undertreated. The significant predictors of NOAC therapy among patients treated 
      with anticoagulants were non-permanent AF (odds ratio [OR] = 1.68, 95% confidence 
      interval [CI] = 1.30-2.18, P = .0001), age-by 5 years (OR = 1.33, 95% 
      CI = 1.16-1.52, P = .0001), and glomerular filtration rate-by 5 units (OR = 1.06, 
      95% CI = 1.02-1.10, P = .0066).A high percentage of AF patients aged >/=75 years 
      receive OACs, mainly NOACs. Most patients are treated according to the current 
      guidelines; under treatment is primarily observed in patients receiving AP 
      therapy. Non-permanent AF, age, and preservation of renal function are 
      significant predictors of NOAC use.
FAU - Gorczyca, Iwona
AU  - Gorczyca I
AUID- ORCID: 0000-0002-7619-8426
AD  - 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre.
AD  - Collegium Medicum, The Jan Kochanowski University.
FAU - Jelonek, Olga
AU  - Jelonek O
AD  - 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre.
FAU - Michalska, Anna
AU  - Michalska A
AD  - Collegium Medicum, The Jan Kochanowski University.
FAU - Chrapek, Magdalena
AU  - Chrapek M
AD  - Faculty of Mathematics and Natural Sciences, The Jan Kochanowski University, 
      Kielce, Poland.
FAU - Walek, Pawel
AU  - Walek P
AD  - 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre.
FAU - Wozakowska-Kaplon, Beata
AU  - Wozakowska-Kaplon B
AD  - 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre.
AD  - Collegium Medicum, The Jan Kochanowski University.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Administration, Oral
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - *Atrial Fibrillation
MH  - *Frail Elderly
MH  - Humans
MH  - Male
MH  - Poland
MH  - Practice Guidelines as Topic
MH  - Practice Patterns, Physicians'/*standards
MH  - Retrospective Studies
MH  - Stroke/*prevention & control
PMC - PMC7373526
EDAT- 2020/07/25 06:00
MHDA- 2020/08/04 06:00
PMCR- 2020/07/17
CRDT- 2020/07/25 06:00
PHST- 2020/07/25 06:00 [entrez]
PHST- 2020/07/25 06:00 [pubmed]
PHST- 2020/08/04 06:00 [medline]
PHST- 2020/07/17 00:00 [pmc-release]
AID - 00005792-202007170-00084 [pii]
AID - MD-D-20-00342 [pii]
AID - 10.1097/MD.0000000000021209 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2020 Jul 17;99(29):e21209. doi: 
      10.1097/MD.0000000000021209.