Clinical profile and outcomes in very elderly patients with atrial fibrillation anticoagulated with rivaroxaban: data from the EMIR study  

作　　者：Francisco Marín Manuel Anguita Sánchez Iñaki Lekuona Marcelo Sanmartín Fernán-dez Vivencio Barrios Carlos Perez Muñoz Juan Cosín-Sales Alejandro IPérez Cabeza Vanesa Roldán Schilling Carles Rafols Priu Esteban Orenes-Piñero María Asunción Es-teve-Pastor 

机构地区：[1]Department of Cardiology,Hospital Clínico Universitario Virgen de la Arrixaca,IMIB-Arrixaca,University of Murcia,CIBERCV,Murcia,Spain [2]Department of Cardiology,Hospital Reina Sofía Córdoba,IMIBIC,University of Cordoba,CIBERCV,Córdoba,Spain [3]Hospital Galdakao-Usansolo,Bizkaia,Spain [4]Department of Cardiology,Hospital Uni-versitario Ramony Cajal,CIBERCV,Madrid,Spain [5]Department of Cardiology,University Hospital Ramóny Cajal,Al-caláUniversity,Madrid,Spain [6]Medical Center La Capillita,Sanlúcar de Barrameda.Private cardiology clinic,Jerez de la Frontera,Spain [7]Department of Cardiology,Hospital Arnau de Vilanova,Valencia,Spain [8]Department of Car-diology,Virgen de la Victoria University Hospital,CIBERCV.Malaga,Spain [9]Department of Haematology,Hospital Clínico Universitario Virgen de la Arrixaca,University of Murcia,Murcia,Spain [10]Department of Medical Affairs,Bayer Hispania,Barcelona,Spain [11]Department of Biochemistry and Molecular Biology-A,University of Murcia,Murcia,Spain

出　　处：《Journal of Geriatric Cardiology》2024年第7期723-732,共10页老年心脏病学杂志（英文版）

基　　金：EMIR Study is sponsored by Bayer

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,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.

关 键 词：PATIENTS ATRIAL BLEEDING 

分 类 号：R541.75[医药卫生—心血管疾病]