Articles producció científica> Medicina i Cirurgia

Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation

  • Identification data

    Identifier: imarina:9229659
    Authors:
    Maria Mostaza, JoseSuarez, CarmenMaria Cepeda, JoseManzano, LuisSanchez, Demetrio
    Abstract:
    Background This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation.
  • Others:

    Author, as appears in the article.: Maria Mostaza, Jose; Suarez, Carmen; Maria Cepeda, Jose; Manzano, Luis; Sanchez, Demetrio
    Department: Medicina i Cirurgia
    URV's Author/s: Auguet Quintillà, Maria Teresa
    Keywords: Warfarin Vitamin k antagonists (vkas) Thromboembolism Stroke prevention Risk stratification schemes Population Nonvalvular atrial fibrillation (nvaf) Mental status questionnaire Management Elderly-patients Direct-acting oral anticoagulants (doacs) Direct oral anticoagulants Bleeding risk Antithrombotic treatment
    Abstract: Background This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation.
    Thematic Areas: Saúde coletiva Psicología Medicina iii Medicina ii Medicina i Matemática / probabilidade e estatística Interdisciplinar Farmacia Educação física Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: mariateresa.auguet@urv.cat
    Author identifier: 0000-0003-0396-6428
    Record's date: 2024-09-28
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-021-02019-0
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Bmc Cardiovascular Disorders. 21 (1): 384-
    APA: Maria Mostaza, Jose; Suarez, Carmen; Maria Cepeda, Jose; Manzano, Luis; Sanchez, Demetrio (2021). Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation. Bmc Cardiovascular Disorders, 21(1), 384-. DOI: 10.1186/s12872-021-02019-0
    Article's DOI: 10.1186/s12872-021-02019-0
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2021
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine
    Warfarin
    Vitamin k antagonists (vkas)
    Thromboembolism
    Stroke prevention
    Risk stratification schemes
    Population
    Nonvalvular atrial fibrillation (nvaf)
    Mental status questionnaire
    Management
    Elderly-patients
    Direct-acting oral anticoagulants (doacs)
    Direct oral anticoagulants
    Bleeding risk
    Antithrombotic treatment
    Saúde coletiva
    Psicología
    Medicina iii
    Medicina ii
    Medicina i
    Matemática / probabilidade e estatística
    Interdisciplinar
    Farmacia
    Educação física
    Ciências biológicas ii
    Ciências biológicas i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
    Biotecnología
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