Abstract
Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectiveness and safety of NOAC in a group at high risk of bleeding complications, in a real-world setting. We conducted a retrospective analysis of a high-risk cohort of 418 patients (pts) followed-up in our anticoagulation unit; data on patient characteristics, anticoagulation treatment, and bleeding and thrombotic complications were evaluated. The population had a median age of 77.8 ± 10.3 years and the mean CHA2DS2-VASc score was 3.85 (SD ± 1.4). Overall, 289 (69.1%) were ≥75 years old. During a mean follow-up time of 51.2 ± 35.7 months, we observed a rate of any bleeding of 7, a clinically relevant non-major bleeding rate of 4.8, a major bleeding rate of 2.2, a stroke rate of 1.6, and a rate of thrombotic events of 0.28 per 100 patient-years. There were 59 hospitalizations due to any cause (14.1%) and 36 (8.6%) deaths (one due to ischemic stroke). A structured follow-up, with judicious prescribing and drug compliance, may contribute to preventing potential complications.
Highlights
Atrial fibrillation (AF) is a highly prevalent arrhythmia; its incidence increases with advancing age, and it is considered a significant cause of mortality worldwide [1,2]
Of particular concern is the risk of intracranial hemorrhage (ICH), which is associated with high rates of mortality and morbidity
Single-center, retrospective cohort study in patients with AF treated with a Nonvitamin K antagonist oral anticoagulants (NOACs) for stroke prevention, who were followed up in the anticoagulation outpatient clinic, and who accomplished more than 12 months of follow-up
Summary
Atrial fibrillation (AF) is a highly prevalent arrhythmia; its incidence increases with advancing age, and it is considered a significant cause of mortality worldwide [1,2]. The risk of thromboembolic events increases with the presence of factors such as advanced age, ventricular dysfunction, arterial hypertension, female gender (when associated with other risk factors), and cardiovascular disease (previous myocardial infarction, arterial disease, or aortic plaques), as well as the previous occurrence of stroke [4,5]. In this context, one of the most important aspects of the treatment of patients with AF is the prevention of thromboembolic events. Of particular concern is the risk of intracranial hemorrhage (ICH), which is associated with high rates of mortality and morbidity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
