Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study

Medientyp: E-Artikel

Titel: Current Use of Oral Anticoagulation Therapy in Elderly Patients with Atrial Fibrillation: Results from an Italian Multicenter Prospective Study—The ISNEP Study

Beteiligte: De Stefano, Francesco; Benassi, Alberto; Cappelletti, Alberto Maria; Donatelli, Francesco; Regazzoli, Damiano; Tolaro, Salvatore; Perego, Francesca; Silverio, Angelo; Scatteia, Alessandra; Guarini, Pasquale; Dellegrottaglie, Santo; Mariani, Simona; Pezzella, Elpidio; Galasso, Gennaro; Caiazza, Francesco

Erschienen: MDPI AG, 2022

Sprache: Englisch

DOI: 10.3390/jpm12091419

ISSN: 2075-4426

Schlagwörter: Medicine (miscellaneous)

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Beschreibung: Background: Atrial fibrillation (AF) is the most common heart arrhythmia, and its prevalence increases with age. Oral Anticoagulant Therapy (OAT) with non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) is essential to avoid thromboembolic events in AF. However, this treatment is associated with a high risk of bleeding and low adherence in elderly patients. Aim: The aim was to evaluate the real-world use of OAT in a population of patients aged ≥80 years in twenty-three Italian centers and to investigate the tolerance of and patient satisfaction with this therapy. Methods: The ISNEP Study is a multicenter cross-sectional study enrolling patients with AF and aged ≥80 years and treated with either NOACs or VKAs. A written questionnaire was administered to each patient to evaluate the adherence to and patient satisfaction with this therapy. Results: The study included 641 patients with a mean age of 85 (82–87) years. The use of NOACs was reported in 93.0% of cases, with the remaining 7.0% treated with VKAs. A history of stroke events was reported in five (11.1%) and one (0.2%) patients in the VKA and NOAC groups, respectively. The rate of referred ecchymosis/epistaxis was significantly higher in the VKA group compared to the NOAC group (p < 0.001). Patients receiving NOACs reported a substantial improvement in their quality of life compared to the VKA group. Conclusions: A small, but not negligible, proportion of elderly AF patients is still treated with VKAs. Patients treated with NOAC have a higher level of satisfaction with the therapy and complete adherence.

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