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Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study.
Marín, Francisco; Sánchez, Manuel Anguita; Lekuona, Iñaki; Fernández, Marcelo Sanmartín; Barrios, Vivencio; Muñoz, Carlos Perez; Cosín-Sales, Juan; Pérez Cabeza, Alejandro I; Schilling, Vanesa Roldán; Priu, Carles Rafols; Orenes-Piñero, Esteban; Esteve-Pastor, María Asunción.
Afiliación
  • Marín F; Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain.
  • Sánchez MA; Department of Cardiology, Hospital Reina Sofía Córdoba, IMIBIC, University of Cordoba, CIBERCV, Córdoba, Spain.
  • Lekuona I; Hospital Galdakao-Usansolo, Bizkaia, Spain.
  • Fernández MS; Department of Cardiology, Hospital Universitario Ramony Cajal, CIBERCV, Madrid, Spain.
  • Barrios V; Department of Cardiology, University Hospital Ramóny Cajal, Alcalá University, Madrid, Spain.
  • Muñoz CP; Medical Center La Capillita, Sanlúcar de Barrameda. Private cardiology clinic, Jerez de la Frontera, Spain.
  • Cosín-Sales J; Department of Cardiology, Hospital Arnau de Vilanova, Valencia, Spain.
  • Pérez Cabeza AI; Department of Cardiology, Virgen de la Victoria University Hospital, CIBERCV. Malaga, Spain.
  • Schilling VR; Department of Haematology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Murcia, Spain.
  • Priu CR; Department of Medical Affairs, Bayer Hispania, Barcelona, Spain.
  • Orenes-Piñero E; Department of Biochemistry and Molecular Biology-A, University of Murcia, Murcia, Spain.
  • Esteve-Pastor MA; Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain.
J Geriatr Cardiol ; 21(7): 723-732, 2024 Jul 28.
Article en En | MEDLINE | ID: mdl-39183954
ABSTRACT

Objectives:

To analyze the clinical profile, adequacy of treatment with rivaroxaban and outcomes in octogenarians with atrial fibrillation (AF), taking rivaroxaban in clinical practice.

Methods:

Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before being included. Data were analyzed according to age (≥ 80 vs. < 80 years) at baseline.

Results:

Out of 1433 patients, 453 (31.6%) were octogenarians at baseline. Compared to younger patients, octogenarians had more comorbidities, higher CHA2DS2-VASc (4.5 ± 1.3 vs. 3.0 ± 1.4; P < 0.001) and HAS-BLED scores (2.0 ± 1.0 vs. 1.4 ± 1.0; P < 0.001). Overall, the dose of rivaroxaban was adequately prescribed in 83.4% of patients, but more frequently in the younger population (71.1% vs. 89.1%; P = 0.039). After a mean follow-up of 2.2 ± 0.6 years, annual rates of stroke + systemic embolism + transient ischemic attack, MACE, cardiovascular death and major bleeding were 1.03%, 1.24%, 1.03% and 1.75%, respectively, in octogenarian patients. Except for progressive heart failure death and major bleeding, rates of outcomes in octogenarians were similar compared to younger patients. In octogenarians, the concomitant use of antiplatelet agents and non-severe dementia were independently associated with the development of ischemic stroke, whereas previous coronary revascularization and heart failure with MACE, and higher HAS-BLED score with major bleeding.

Conclusions:

In clinical practice, around one third of patients taking rivaroxaban are octogenarians. These patients have many comorbidities and a high thromboembolic risk. Despite that, rates of adverse events remain low. Rivaroxaban is adequately prescribed in the majority of octogenarians.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Geriatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: China
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Geriatr Cardiol Año: 2024 Tipo del documento: Article País de afiliación: España Pais de publicación: China