Universität zu Köln

Pilotto, Alberto, Veronese, Nicola ORCID: 0000-0002-9328-289X, Polidori, Maria Cristina, Strandberg, Timo, Topinkova, Eva ORCID: 0000-0002-6786-4116, Cruz-Jentoft, Alfonso J., Custodero, Carlo and Maggi, Stefania (2022). The role of prognostic stratification on prescription of anticoagulants in older patients with atrial fibrillation: a multicenter, observational, prospective European study (EUROSAF). Ann. Med., 54 (1). S. 2411 - 2420. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1365-2060

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Abstract

Background: Literature suggests that different risks of mortality could influence physicians in prescribing or not anticoagulants in older patients with atrial fibrillation (AF). The Multidimensional Prognostic Index (MPI) can be considered a tool for the detection of multidimensional frailty. The aim of this cross-sectional study was to evaluate whether prescription patterns of oral anticoagulants exist, based on MPI values. Methods: Older hospitalised patients (age >= 65 years) with non-valvular AF were included across 24 European centres. MPI was calculated using validated and standardised tools derived from a comprehensive geriatric assessment. Other functional and clinical information were collected to calculate indexes specific for haemorrhagic and thromboembolic risk in AF. Results: Altogether, 2,012 participants affected by AF (mean age was 83.2 +/- 7.5, range: 65-104 years), with a higher presence of women (57.0%), were included. Overall, 440 took vitamin K antagonists VKAs (22.0%), 667 (33.4%) direct oral anticoagulants (DOACs), whilst 44.6% did not take any anticoagulant treatment. Prescription of anticoagulants was associated with MPI values, with people taking anticoagulants having lower mean MPI values. Anticoagulant therapy was not used in 53.1% of the group with the highest risk of mortality, compared with 32.3% of those in the group with the lowest mortality risk. People with higher scores in MPI were less frequently treated with anticoagulant therapy, after adjusting for several potential confounders. Conclusions: The EURopean study of Older Subjects with Atrial Fibrillation (EUROSAF) suggested that almost half of the older persons with AF do not receive anticoagulants and that MPI is an important determinant in prescribing or not anticoagulants.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pilotto, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Veronese, Nicola UNSPECIFIED orcid.org/0000-0002-9328-289X UNSPECIFIED Polidori, Maria Cristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Strandberg, Timo UNSPECIFIED UNSPECIFIED UNSPECIFIED Topinkova, Eva UNSPECIFIED orcid.org/0000-0002-6786-4116 UNSPECIFIED Cruz-Jentoft, Alfonso J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Custodero, Carlo UNSPECIFIED UNSPECIFIED UNSPECIFIED Maggi, Stefania UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691368
DOI:	10.1080/07853890.2022.2117407
Journal or Publication Title:	Ann. Med.
Volume:	54
Number:	1
Page Range:	S. 2411 - 2420
Date:	2022
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1365-2060
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ELDERLY-PATIENTS; VALIDATION; MORTALITY; STROKE; ADULTS; INDEX Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69136