التفاصيل البيبلوغرافية
| العنوان: |
Oral anticoagulation improves the prognosis of octogenarian patients with atrial fibrillation undergoing percutaneous coronary intervention and stenting. |
| المؤلفون: |
Caballero, Luis, Ruiz-Nodar, Juan M., Marín, Francisco, Roldán, Vanessa, Hurtado, Jose A., Valencia, Jose, Manzano-Fernandez, Sergio, Sogorb, Francisco, Valdes, Mariano, Lip, Gregory Y. H. |
| المصدر: |
Age & Ageing; Jan2013, Vol. 42 Issue 1, p70-75, 6p, 4 Charts, 1 Graph |
| مصطلحات موضوعية: |
ANTICOAGULANTS, ADVERSE health care events, ATRIAL fibrillation, COMBINATION drug therapy, CHI-squared test, CONFIDENCE intervals, REPORTING of diseases, EPIDEMIOLOGY, FISHER exact test, MYOCARDIAL revascularization, ORAL drug administration, SCALES (Weighing instruments), STATISTICAL hypothesis testing, SURGICAL stents, SURVIVAL analysis (Biometry), T-test (Statistics), TRANSLUMINAL angioplasty, U-statistics, DATA analysis, MULTIPLE regression analysis, CONTROL groups, PROPORTIONAL hazards models, RETROSPECTIVE studies, DATA analysis software, DESCRIPTIVE statistics, KAPLAN-Meier estimator, OLD age |
| مستخلص: |
Background: a significant proportion of octogenarian patients with atrial fibrillation (AF) undergo percutaneous coronary intervention (PCI) with stenting. Dual antiplatelet therapy is recommended in these patients, requiring a period of triple therapy with dual antiplatelet agent plus oral anticoagulation (OAC). Concerns remain regarding the appropriateness of OAC in octogenarians.Methods: we reviewed 604 patients (15.7% ≥80 years) with AF undergoing PCI. Clinical follow-up was performed, recording any bleeding episode, thrombo-embolism and major adverse cardiac events (MACE = death, acute myocardial infarction and/or revascularisation of target lesion). We compared octogenarian patients in relation to treatment with OAC at discharge. A secondary aim was to compare octogenarian patients with non-octogenarian patients in terms of their clinical and demographic characteristics, management and clinical outcome.Results: among the 604 patients, 95(15.7%) were aged ≥80 years. Octogenarians had a higher median CHADS2 score (2.78 versus 2.01; P < 0.001) and HAS-BLED score (3.05 versus 2.84; P = 0.028). After a follow-up of 17 ± 14 months, all-cause death occurred in 33%, MACE in 44%, and major bleeding in 21%. OAC was associated with less MACE (28.9 versus 58.3%; P = 0.012) and a similar rate of major bleeding. On multivariable analysis, non-use of OAC at discharge was associated with increased MACE (OR = 4.3; 95% CI = 1.3–14.6; P = 0.02).Conclusion: octogenarian AF patients undergoing PCI/stenting have a high mortality rate and MACE, which can be reduced by means of OAC therapy. [ABSTRACT FROM PUBLISHER] |
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| قاعدة البيانات: |
Complementary Index |
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