Non-vitamin K vs vitamin K oral anticoagulants in patients aged > 80 year with atrial fibrillation and low body weight.

European Journal of Clinical Investigation
Vincenzo RussoGerardo Nigro

Abstract

Octogenarian patients are at high risk of both ischaemic and bleeding events, and the low body weight is considered a risk factor for major bleeding in atrial fibrillation (AF) patients on anticoagulation therapy. The aim of our study was to compare the safety and effectiveness of NOACs versus well-controlled VKA therapy among patients aged > 80 year with AF and low body weight in real-life setting. Data for this study were sourced from the multicenter prospectively maintained Atrial Fibrillation Research Database (NCT03760874). From this, we selected AF patients aged ≥ 80 years and weighted ≤ 60 kg who received NOACs or VKAs treatment (only those with a time in therapeutic range > 70%). 279 patients (136 in NOAC group and 143 in VKA group) were selected. A total of 71 patients (17 in NOAC vs 54 in VKA group) died during the follow-up. The incidence rate of all-cause mortality was 27.70 per 100 person-years (14.91 in NOAC vs 37.94 in VKA group, adjusted hazard ratio 0.43; 95% CI 0.25 to 0.975; P = .003). 22 patients (9 in NOAC vs 13 in VKA group, P = .6) had major bleeding events. Diabetes mellitus, COPD and age resulted positively associated with death, whereas NOACs, parossistic AF and weight negatively associated with mortal...Continue Reading

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Citations

Nov 23, 2020·European Journal of Clinical Investigation·Woldesellassie M BezabheGregory M Peterson
Jan 1, 2021·European Heart Journal Supplements : Journal of the European Society of Cardiology·Itamar S SantosUNKNOWN NIHR Global Health Group on Atrial Fibrillation Management
Feb 27, 2021·Seminars in Thrombosis and Hemostasis·Francesca RenonVincenzo Russo
Mar 7, 2021·International Journal of Environmental Research and Public Health·Vincenzo RussoGerardo Nigro

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