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Antithrombotic treatment for newly diagnosed atrial fibrillation in relation to patient age: the GLORIA-AF registry programme.

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机构: [1]Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland. [2]Icahn School of Medicine at Mount Sinai, New York, NY, USA. [3]Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands. [4]Department of Neurology, University of Duisburg, Essen, Germany. [5]Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina. [6]Department of Cardiology, Atrial Fibrillation Center, Beijing AnZhen Hospital, Capital Medical University, Beijing, China. [7]RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC, USA. [8]Population Health Research Institute, McMaster University, Hamilton, ON, Canada. [9]Department of Clinical Development and Medical Affairs, Boehringer Ingelheim Pharma GmbH und Co KG, Ingelheim, Germany. [10]Department of Medicine, Boehringer Ingelheim, Burlington, Canada. [11]Global Epidemiology, Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany. [12]Department of Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA. [13]Hannover Medical School, Hannover, Germany. [14]Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
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To assess antithrombotic therapy choices in relation to patient age in a large, global registry on atrial fibrillation (AF). Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) is an international programme involving patients with newly diagnosed AF and ≥1 risk factors for stroke. We used Phase II data (from November 2011 through December 2014), which commenced immediately following first non-vitamin K antagonist oral anticoagulants (NOACs) approval in participating countries. Of 15 092 patients (mean age 70.5 ± 11.0 years), enrolled at 982 centres, 26.9% were aged <65 years, 33.9% 65-74, 30.5% 75-84, and 8.6% ≥85 years old. Oral anticoagulant (OAC) use was 73.5%, 81.4%, 83.3%, and 82.3% (overall NOACs use was 44.4%, 49.7%, 48.7%, and 45.6%) for those aged <65, 65-74, 75-84 and ≥85 years, respectively. Corresponding proportions for antiplatelet monotherapy and no treatment were: 16.2% and 10.2%; 11.2% and 7.3%; 10.0% and 6.5%; 10.5% and 7.0%, respectively. Of those aged 65-74, 75-84, and ≥85 years, respectively, 83.7, 86.8 and 85.4% received OAC unless bleeding risk was high (HAS-BLED ≥3), whereby 64.1%, 63.5%, and 64.5% were anticoagulated, and 31.1%, 30.3%, and 31.3% received antiplatelets only. Of patients ≥85 years, OAC use was 88.1% in Europe (NOAC 45.1%), 79.5% in North America (NOAC 44.8%), and 54.1% in Asia (NOAC 40.2%). Despite geographic differences in OAC use, neither OAC nor NOAC uptake was lower for patients ≥85 years old compared with younger patients. Although the majority of patients was prescribed OAC at all ages, nearly one-third received antiplatelet monotherapy when bleeding risk was increased. http://www.clinicaltrials.gov. Unique identifier: NCT01468701. © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 心脏和心血管系统
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第一作者机构: [1]Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland.
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