Clinical profile and outcomes in very elderly patients with at-rial fibrillation anticoagulated with rivaroxaban:data from the EMIR study
Francisco Marín1
Manuel Anguita Sánchez2
Iñaki Lekuona3
Marcelo Sanmartín Fernán-dez4
Vivencio Barrios5
Carlos Perez Muñoz6
Juan Cosín-Sales7
Alejandro I.Pérez Cabeza8
Vanesa Roldán Schilling9
Carles Rafols Priu10
Esteban Orenes-Piñero11
María Asunción Es-teve-Pastor1
1.Department of Cardiology,Hospital Clínico Universitario Virgen de la Arrixaca,IMIB-Arrixaca,University of Murcia,CIBERCV,Murcia,Spain2.Department of Cardiology,Hospital Reina Sofía Córdoba,IMIBIC,University of Cordoba,CIBERCV,Córdoba,Spain3.Hospital Galdakao-Usansolo,Bizkaia,Spain4.Department of Cardiology,Hospital Uni-versitario Ramony Cajal,CIBERCV,Madrid,Spain5.Department of Cardiology,University Hospital Ramóny Cajal,Al-calá University,Madrid,Spain6.Medical Center La Capillita,Sanlúcar de Barrameda.Private cardiology clinic,Jerez de la Frontera,Spain7.Department of Cardiology,Hospital Arnau de Vilanova,Valencia,Spain8.Department of Car-diology,Virgen de la Victoria University Hospital,CIBERCV.Malaga,Spain9.Department of Haematology,Hospital Clínico Universitario Virgen de la Arrixaca,University of Murcia,Murcia,Spain10.Department of Medical Affairs,Bayer Hispania,Barcelona,Spain11.Department of Biochemistry and Molecular Biology-A,University of Murcia,Murcia,Spain
摘要：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,anticoagu-lated 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 ische-mic 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 com-pared to younger patients.In octogenarians,the concomitant use of antiplatelet agents and non-severe dementia were independ-ently 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 pre-scribed in the majority of octogenarians.
机标关键词：clinicalprofilestudywithdatafromanticoagulatedat-rial
论文发表日期：2024-07-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 723-732 )