Artikel ; Online: Comparison of Low-Dose Direct Acting Anticoagulant and Warfarin in patients Aged ≥80 years With Atrial Fibrillation.
The American journal of cardiology
2021 Band 152, Seite(n) 69–77
Abstract: Low dose direct acting oral anticoagulants (LDDOACS) were approved for elderly atrial Fibrillation (AF) patients with limited information. A retrospective analysis collecting baseline characteristics and outcomes in AF patients ≥ 80 prescribed LDDOAC or ... ...
Abstract | Low dose direct acting oral anticoagulants (LDDOACS) were approved for elderly atrial Fibrillation (AF) patients with limited information. A retrospective analysis collecting baseline characteristics and outcomes in AF patients ≥ 80 prescribed LDDOAC or warfarin (W), from a multidisciplinary practice between 1/1/11 (First LDDOAC available) and 5/31/17 was conducted. From 9660 AF patients, 514 ≥ 80 received a LDDOAC and 422 W. A multivariable comparison found LDDOAC patients were older (p <0.001), had lower creatinine clearance (CrCl) (p = 0.006), used more anti-platelet drugs (p <0.001), and more often had new onset AF verses those prescribed W (p <0.001). There were no clinically significant differences among those patients receiving Dabigatran 75 mgs BID (D), Rivaroxaban 15mgs (R) or Apixaban 2.5mgs BID (A). Forty-eight and 50% of the patients remained on their LDDOAC or W for the observation period (p = 0.55). Stroke/systemic embolism (SSE) and CNS bleeds were 1.16 vs 2.22%/yr., (p = 0.143) and 1.46 vs 0.93%/yr., (p = 0.24). Mortality and major bleeds were 6.26 vs 1.67%/yr., and 12.3vs 3.77%/yr. (p <0.001). SSE were 1.1%/yr for D, R, and A (p = 0.94). CNS bleeds were 2.2 for D, 1.7 for R and 0.8%/yr. for A: p = 0.53. Major bleeding was: 14.3 for D, 14.1 for R and 9.1%/yr. for A, p = 0.048 (with A < R, p = 0.01). Mortality was 5.5 for D, 4.2 for R and 9.5% for A, p = 0.031. In conclusion, half the patients remained on their assigned anti-coagulant. SSE and intracranial bleed rates were similar and low. Major bleeds and deaths were different between groups emphasizing the need for prospective randomized trials in this growing population with AF. |
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Mesh-Begriff(e) | Age Factors ; Aged, 80 and over ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Dabigatran/administration & dosage ; Dabigatran/therapeutic use ; Embolism/etiology ; Embolism/prevention & control ; Factor Xa Inhibitors/administration & dosage ; Factor Xa Inhibitors/therapeutic use ; Female ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Humans ; Intracranial Hemorrhages/chemically induced ; Intracranial Hemorrhages/epidemiology ; Male ; Multivariate Analysis ; Platelet Aggregation Inhibitors/therapeutic use ; Pyrazoles/administration & dosage ; Pyrazoles/therapeutic use ; Pyridones/administration & dosage ; Pyridones/therapeutic use ; Retrospective Studies ; Rivaroxaban/administration & dosage ; Rivaroxaban/therapeutic use ; Stroke/etiology ; Stroke/prevention & control ; Warfarin/therapeutic use |
Chemische Substanzen | Anticoagulants ; Factor Xa Inhibitors ; Platelet Aggregation Inhibitors ; Pyrazoles ; Pyridones ; apixaban (3Z9Y7UWC1J) ; Warfarin (5Q7ZVV76EI) ; Rivaroxaban (9NDF7JZ4M3) ; Dabigatran (I0VM4M70GC) |
Sprache | Englisch |
Erscheinungsdatum | 2021-06-20 |
Erscheinungsland | United States |
Dokumenttyp | Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't |
ZDB-ID | 80014-4 |
ISSN | 1879-1913 ; 0002-9149 |
ISSN (online) | 1879-1913 |
ISSN | 0002-9149 |
DOI | 10.1016/j.amjcard.2021.04.035 |
Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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