Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Measures
2.3. Statistical Analysis
3. Results
4. Discussion
- -
- In elderly patients, there was still a significant portion of this population treated with VKAs;
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- The patients’ satisfaction with therapy was higher in the NOAC group.
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Informed Consent Statement
Conflicts of Interest
References
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Overall Population (N = 641) | NOAC (N = 596) | VKA (N = 45) | p | |
---|---|---|---|---|
Age, years | 85 (82–87) | 85 (82–87) | 86 (82–88) | 0.384 |
Male sex, N (%) | 275 (42.9) | 259 (43.5) | 16 (35.6) | 0.302 |
Weight, kg | 71.0 ± 12.4 | 71.1 ± 12.4 | 68.5 ± 12.2 | 0.167 |
Height, cm | 164.7 ± 77.1 | 164.8 ± 8.7 | 164.0 ± 10.0 | 0.557 |
BMI, kg/m2 | 25.5 ± 3.7 | 25.5 ± 3.7 | 24.8 ± 3.2 | 0.209 |
SAP, mmHg | 140 (130–154) | 140 (130–154) | 135 (125–155) | 0.493 |
DAP, mmHg | 80 (75–90) | 85 (75–90) | 80 (70–80) | <0.001 |
Diabetes, N (%) | 200 (31.2) | 191 (32.0) | 9 (20.0) | 0.093 |
Dyslipidemia, N (%) | 258 (40.2) | 239 (40.1) | 19 (42.2) | 0.780 |
Smoking status, N (%) | ||||
Never | 447 (69.7) | 412 (69.1) | 35 (77.8) | 0.049 |
Previous | 123 (19.2) | 113 (19.0) | 10 (22.2) | |
Active | 71 (11.1) | 71 (11.9) | 0 | |
Paroxysmal AF, N (%) | 96 (15.0) | 93 (15.6) | 3 (6.7) | 0.268 |
Persistent AF, N (%) | 41 (6.4) | 38 (6.4) | 3 (6.7) | |
Permanent AF, N (%) | 504 (78.6) | 465 (78.0) | 39 (86.7) | |
CAD, N (%) | 181 (28.2) | 171 (28.7) | 10 (22.2) | 0.353 |
HF, N (%) | 198 (30.9) | 188 (31.5) | 10 (22.2) | 0.192 |
LVEF, N (%) | ||||
≥50% | 468 (73.0) | 439 (73.7) | 29 (64.4) | 0.406 |
40–49% | 140 (21.8) | 127 (21.3) | 13 (28.9) | |
<40% | 33 (5.1) | 30 (5.0) | 3 (6.7) | |
Prior stroke/TIA, N (%) | 91 (14.2) | 77 (12.9) | 14 (31.1) | <0.001 |
PAD, N (%) | 123 (19.2) | 115 (19.3) | 8 (17.8) | 0.803 |
eGFR, mL/min | 50.0 (41.5–66.0) | 51 (42–67) | 45 (39–55) | 0.003 |
Liver disease, N (%) | 7 (1.1) | 6 (1.0) | 1 (2.2) | 0.449 |
Concomitant medications | ||||
Non-dihydropyridine CCB, N (%) | 58 (9.0) | 54 (9.1) | 4 (8.9) | 0.969 |
Antiarrhythmic drugs, N (%) | 101 (15.8) | 90 (15.1) | 11 (24.4) | 0.097 |
ACEi, N (%) | 280 (43.7) | 265 (44.5) | 15 (33.3) | 0.147 |
Beta-blockers, N (%) | 481 (75.0) | 451 (75.7) | 30 (66.7) | 0.178 |
Sartans, N (%) | 156 (24.3) | 140 (23.5) | 16 (35.6) | 0.069 |
Ranolazine, N (%) | 16 (2.5) | 16 (2.7) | 0 | 0.266 |
Statins, N (%) | 312 (48.7) | 296 (49.7) | 16 (35.6) | 0.068 |
Prior bleeding, N (%) | 31 (4.8) | 28 (4.7) | 3 (6.7) | 0.553 |
Chronic use of antiplatelet agents or NSAIDs, N (%) | 45 (7.0) | 39 (6.5) | 6 (13.3) | 0.086 |
Overall Population (N = 641) | NOAC (N = 596) | VKA (N = 45) | p | |
---|---|---|---|---|
Duration of OAT since initiation, months | 36 (17–45) | 36 (17–42) | 36 (13–81) | 0.189 |
History of anemia during OAT, N (%) | 36 (5.6) | 34 (5.7) | 2 (4.4) | 0.723 |
History of GI bleeding during OAT, N (%) | 16 (2.5) | 14 (2.3) | 2 (4.4) | 0.385 |
History of major bleeding during OAT, N (%) | 13 (2.0) | 12 (2.0) | 1 (2.2) | 0.924 |
History of minor bleeding during OAT, N (%) | 43 (6.7) | 38 (6.4) | 5 (11.1) | 0.221 |
History of severe thrombocytopenia during OAT, N (%) | 2 (0.3) | 2 (0.3) | 0 | 0.697 |
History of stroke during OAT, N (%) | 6 (0.9) | 1 (0.2) | 5 (11.1) | <0.001 |
History of TIA during OAT, N (%) | 16 (2.5) | 11 (1.8) | 5 (11.1) | <0.001 |
History of ACS during OAT, N (%) | 17 (2.7) | 13 (2.2) | 4 (8.9) | 0.007 |
Overall Population (N = 641) | NOAC (N = 596) | VKA (N = 45) | p | |
---|---|---|---|---|
The patient is informed about drug–drug and food–drug interactions | 529 (82.5) | 492 (82.6) | 37 (82.2) | 0.189 |
The patient reports significant side effects from OAT | 20 (3.1) | 16 (2.7) | 4 (8.9) | 0.021 |
The patient reports ecchymosis | 68 (10.6) | 55 (9.2) | 13 (28.9) | <0.001 |
The patient reports epistaxis | 17 (2.7) | 12 (2.0) | 5 (11.1) | <0.001 |
The patient reports bleeding | 22 (3.4) | 20 (3.4) | 2 (4.4) | 0.699 |
OAT initiation improved the patient’s quality of life | ||||
No | 72 (11.2) | 62 (10.4) | 10 (22.2) | <0.001 |
Low | 72 (11.2) | 60 (10.1) | 12 (26.7) | |
Enough | 276 (43.1) | 260 (43.6) | 16 (35.6) | |
Complete | 221 (34.5) | 214 (35.9) | 7 (15.6) |
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De Stefano, F.; Benassi, A.; Cappelletti, A.M.; Donatelli, F.; Regazzoli, D.; Tolaro, S.; Perego, F.; Silverio, A.; Scatteia, A.; Guarini, P.; et al. Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study. J. Pers. Med. 2022, 12, 1419. https://doi.org/10.3390/jpm12091419
De Stefano F, Benassi A, Cappelletti AM, Donatelli F, Regazzoli D, Tolaro S, Perego F, Silverio A, Scatteia A, Guarini P, et al. Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study. Journal of Personalized Medicine. 2022; 12(9):1419. https://doi.org/10.3390/jpm12091419
Chicago/Turabian StyleDe Stefano, Francesco, Alberto Benassi, Alberto Maria Cappelletti, Francesco Donatelli, Damiano Regazzoli, Salvatore Tolaro, Francesca Perego, Angelo Silverio, Alessandra Scatteia, Pasquale Guarini, and et al. 2022. "Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study" Journal of Personalized Medicine 12, no. 9: 1419. https://doi.org/10.3390/jpm12091419