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