482Direct oral anticoagulant rivaroxaban in very old and frail patients: A one-year prospective follow-up of a large-scale cohort (SAFIR-AC)
| العنوان: | 482Direct oral anticoagulant rivaroxaban in very old and frail patients: A one-year prospective follow-up of a large-scale cohort (SAFIR-AC) |
|---|---|
| المؤلفون: | O. Guerin, J P David, G. Sacco, Edouard Chaussade, M Lillamand, E. Paillaud, P. Jouanny, Laurent Fauchier, P. Krolak-Salmon, N. Boulloche, M. Bonnefoy, Olivier Hanon, J Vidal, G. Berrut, U. Vinsonneau |
| المصدر: | European Heart Journal. 40 |
| بيانات النشر: | Oxford University Press (OUP), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Rivaroxaban, Pediatrics, medicine.medical_specialty, Mini–Mental State Examination, medicine.diagnostic_test, Anemia, business.industry, Atrial fibrillation, medicine.disease, Comorbidity, Cohort, CHA2DS2–VASc score, medicine, Oral anticoagulant, Cardiology and Cardiovascular Medicine, business, medicine.drug |
| الوصف: | Background/Introduction Age is one of the strongest predictors/risk factors for ischemic stroke in subjects with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) have been shown to be effective in the prevention of this condition; however, clinical evidence on bleeding risk with this therapeutic strategy in very old and frail geriatric patients is poor. Purpose To assess bleeding risk in French geriatric patients aged ≥80 years and diagnosed with AF newly treated with rivaroxaban. Methods Subjects, presenting to one of 33 geriatric centers, with non-valvular AF and recent initiation of a treatment with rivaroxaban were enrolled in the study and followed-up every 3 months for 12 months. Clinical and routine laboratory data and evaluation scores, such as HAS-BLED, HEMORR2HAGES, ATRIA, and CHA2DS2-VASc, as well as comprehensive geriatric evaluation were reported. Major bleeding, as defined in ROCKET AF study, was reported at each visit, and this primary outcome was adjudicated by an independent committee. Results of this cohort were compared with findings from a similar cohort treated with vitamin K antagonists (VKAs) from the same centers (n=924). Results A total of 1045 subjects were enrolled in the study of whom 995 (95%) had a one-year follow-up (analyzed population). The mean (standard deviation (SD)) age was 86.0 (4.3) years, with the majority of patients being female (61%), 23% aged 90 years or older, and 48% having an estimated glomerular filtration rate (eGFR) Conclusions This is the first large-scale prospective study in geriatric population in AF subjects treated with DOAC (rivaroxaban) Major bleeding risk appeared higher in very old than younger population, however major bleeding and ICH rates were significantly lower with rivaroxaban than with VKAs when used in the same geriatric population. This study indicates that Rivaroxaban can be used in very old and frail patients for the treatment of non-valvular AF. Acknowledgement/Funding Unrestricted grant from Bayer |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::821d40fc957c892f205292a07b30afa0 https://doi.org/10.1093/eurheartj/ehz747.0132 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........821d40fc957c892f205292a07b30afa0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
|---|