TORNA ALL’ELENCO

Low bleeding risk of very old atrial fibrillation women on VKA treatment: Results from a prospective collaborative study. on behalf of the ad hoc study group of FCSA in Journal of Thrombosis and Haemostasis

2011
ASL Torino 5

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (13)Vedi tutti...

Poli D

Antonucci E

Grifoni E


et alii...

Abstract

Background: The increasing number of very old patients with atrial fibrillation (AF) on treatment with vitamin K antagonists (VKAs) requires a better knowledge of the risks associated with this treatment in elderly. We performed a prospective collaborative study among Centres affiliated to FCSA to assess the adverse events of VKAs in AF patients who started treatment after 80 years of age. Methods: In this study we analyse the difference of clinical event rates (bleeding and stroke) between genders. Quality of anticoagulation and adverse events occurring during follow-up were recorded. Results: The total number of patients recruited was 3015 patients (males 45%; 7620 patient-years; mean time of follow-up 2.52 years). The total quality of anticoagulation measured as time spent within, above and below the international normalized ratio therapeutic range was 63%, 14% and 23%, respectively (IQR for time in therapeutic range [TTR] 50-75). During follow-up 132 major bleeding events (1.73 × 100 patient-years) were recorded. Females show a lower bleeding risk (1.4 × 100 patient-years) than males (rate 2.2 × 100 patient-years) (P = 0.0001), even if they are significantly older (P = 0.000). We confirmed a trend to a higher risk of stroke in females. No difference in TTR was recorded, however, males spent a longer time above the TR (P = 0.002). Conclusion: In conclusion, very old AF women on VKA treatment carry a low bleeding risk with respect to males, suggesting a more favourable risk/benefit ratio of treatment.

DOI : 10.1111/j.1538-7836.2011.04380_4.x

Keywords

cerebrovascular accident; follow up; male; patient; society; hemostasis; female; atrial fibrillation; very elderly; risk; thrombosis; bleeding; human; antivitamin K; anticoagulation; aged; international normalized ratio; gender;