Background and objectives : The clinical practice of anticoagulation in anticoagulant-naïve octogenarians with non-valvular atrial fibrillation (NVAF) has not been established in a real-world setting. We aimed to investigate the real-world prescription for anticoagulation and to compare the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin vs. no anticoagulation in anticoagulant-naïve octogenarian NVAF patients.
Subjects and methods : From January 1, 2013 to August 31, 2015, we identified 89 consecutive newly detected NVAF patients aged ≥80 years. We retrospectively reviewed medical records until May 31, 2017 according to the differences in anticoagulation prescription (no anticoagulation, 39 patients; NOACs, 17; warfarin, 33). The efficacy outcome was stroke or systemic embolism. The safety outcome was total and major bleeding.
Results : Stroke incidence did not differ significantly among the prescriptions (no anticoagulation, 2.41; NOACs, 3.55; and warfarin, 1.28 per 100 patient-years). Considerable incidence of major bleeding was observed in the anticoagulation groups (no anticoagulation, no events; NOACs, 12.11; and warfarin, 4.30 per 100 patient-years, p = 0.570). Total bleeding tended to be high in the NOAC and warfarin groups compared to no anticoagulation (no anticoagulation, 1.21; NOACs, 20.91; warfarin, 10.76 per 100 patient-years, p = 0.054). In the multivariable Cox proportional hazard model, previous bleeding history, warfarin and NOACs treatment were significant predictors for total bleeding.
Conclusion: The occurrence of total and major bleeding was excessively high in the anticoagulation groups (NOACs or warfarin) compared to the no anticoagulation group. Future study is required to optimize anticoagulant regimen in octogenarian subjects.
Keywords:
Published on: Jun 8, 2020 Pages: 188-194
Full Text PDF
Full Text HTML
DOI: 10.17352/2455-2976.000135
CrossMark
Publons
Harvard Library HOLLIS
Search IT
Semantic Scholar
Get Citation
Base Search
Scilit
OAI-PMH
ResearchGate
Academic Microsoft
GrowKudos
Universite de Paris
UW Libraries
SJSU King Library
SJSU King Library
NUS Library
McGill
DET KGL BIBLiOTEK
JCU Discovery
Universidad De Lima
WorldCat
VU on WorldCat
PTZ: We're glad you're here. Please click "create a new query" if you are a new visitor to our website and need further information from us.
If you are already a member of our network and need to keep track of any developments regarding a question you have already submitted, click "take me to my Query."