TY - JOUR
T1 - Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation
AU - Mostaza, José M
AU - Suarez, Carmen
AU - Cepeda, Jose María
AU - Manzano, Luis
AU - Sánchez, Demetrio
AU - Sánchez Lora, Fernando Javier
AU - Ibañez Bermúdez, Francisco
AU - Jurado Porcel, Ana María
AU - Salgado Ordoñez, Fernando
AU - Rivera Civico, Francisco
AU - Díez García, Luis Felipe
AU - Jaén Águila, Fernando
AU - Geraldía Lama, Manuel
AU - Peral Gutiérrez-Ceballos, Enrique
AU - Domínguez, Antonia
AU - Astudillo Martín, Francisco
AU - Aguilar Cortes, Eduardo
AU - Ferrando Vela, Juan
AU - García Aranda, Alfonso
AU - Sánchez Cembellín, Mercedes
AU - López Caleya, Juan Francisco
AU - Ruiz, Sixto
AU - Rodríguez Gaspar, Melchor
AU - Conde-Martel, Alicia
AU - Hernández Hernández, José Luis
AU - Abascal Carrera, Ismael
AU - Pérez del Molino Castellanos, Alfonso
AU - Fernández Pérez, Esther
AU - Martínez Acitores, Juan Carlos
AU - Seisdedos Cortes, Luis Miguel
AU - Abad Manteca, Laura
AU - Budiño Sánchez, Marco
AU - Moreno Palomares, José Javier
AU - Coca Prieto, Inmaculada
AU - Muñoz, Ana Isabel
AU - Sánchez Castaño, Ángel
AU - Ruiz Ribó, Lola
AU - Mascaró, Jordi
AU - Morcillo Serra, César
AU - Auguet, Teresa
AU - Marimón, Francesc
AU - Fernández Solá, Joaquín
AU - Suriñach, José María
AU - Marchena, Pablo
AU - Riera Mestre, Antoni
AU - Armario, Pedro
AU - García Bragado, Ferrán
AU - del Molino, Fátima
AU - Sacristán, Oscar
AU - Almagro, Pere
AU - Falgà, Conxita
AU - Muñoz Rodríguez, Francisco José
AU - Riesco, None
AU - Romero Requena, Jorge
AU - Arévalo Lorido, José Carlos
AU - Chiquero Palomo, Manuela
AU - de la Cruz, Ana Isabel
AU - Pijerro, Agustín
AU - Fernández Bouza, Elena
AU - González Soler, Juan José
AU - Núñez Fernández, Manuel Jesús
AU - De La Fuente Aguado, Javier
AU - Díaz Peromingo, José Antonio
AU - Fernández-Martín, Julián
AU - Daroca Pérez, Rafael
AU - Castiella Herrero, Jesús
AU - Carreño, M.Cruz
AU - Gómez Cerezo, Jorge
AU - Pontes Navarro, José Carlos
AU - Varona Arche, José Felipe
AU - Ferreiro López, Daniel
AU - Muñoz Calvo, Benjamín
AU - Casado Cerrada, José Manuel
AU - Fidalgo Montero, María del Pilar
AU - Casas Rojo, José Manuel
AU - Herreros, Benjamín
AU - Cuevas Tascón, Guillermo
AU - Muiño Miguez, Antonio
AU - Marrero Francés, Jorge
AU - Ortega, Nicolas
AU - Trujillo, Javier
AU - Sánchez Álvarez, Julio
AU - Catalán Ramos, Jose Ignacio
AU - Fresco Benito, Francisco Javier
AU - Anuzita Alegría, Ainhoa
AU - Teruel, Carlos
AU - Artero Mora, Arturo
AU - Moral, Pedro
AU - Seguí Ripoll, José Miguel
AU - Bonilla Rovira, Fernando
AU - Maestre Peiro, Ana
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Antithrombotic treatment
KW - Direct-acting oral anticoagulants (DOACs)
KW - Nonvalvular atrial fbrillation (NVAF)
KW - Vitamin K antagonists (VKAs)
UR - https://www.scopus.com/pages/publications/85112352069
U2 - 10.1186/s12872-021-02019-0
DO - 10.1186/s12872-021-02019-0
M3 - Article
C2 - 34372782
SN - 1471-2261
VL - 21
JO - BMC Cardiovascular Disorders
JF - BMC Cardiovascular Disorders
IS - 1
ER -