Publicação
Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation
| Resumo: | 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. |
|---|---|
| Autores principais: | Silva Cunha, Pedro |
| Outros Autores: | Viveiros Monteiro, André; Coutinho Cruz, Madalena; Malveiro, Paula; Reis, João Pedro; Portugal, Guilherme; Dias, Ana; Ferreira, Rui Cruz; Oliveira, Mario |
| Assunto: | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1869347367363280896 |
|---|---|
| author | Silva Cunha, Pedro |
| author2 | Viveiros Monteiro, André Coutinho Cruz, Madalena Malveiro, Paula Reis, João Pedro Portugal, Guilherme Dias, Ana Ferreira, Rui Cruz Oliveira, Mario |
| author2_role | author author author author author author author author |
| author_facet | Silva Cunha, Pedro Viveiros Monteiro, André Coutinho Cruz, Madalena Malveiro, Paula Reis, João Pedro Portugal, Guilherme Dias, Ana Ferreira, Rui Cruz Oliveira, Mario |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Silva Cunha, Pedro\"},{\"Person.name\":\"Viveiros Monteiro, André\"},{\"Person.name\":\"Coutinho Cruz, Madalena\"},{\"Person.name\":\"Malveiro, Paula\"},{\"Person.name\":\"Reis, João Pedro\"},{\"Person.name\":\"Portugal, Guilherme\"},{\"Person.name\":\"Dias, Ana\"},{\"Person.name\":\"Ferreira, Rui Cruz\"},{\"Person.name\":\"Oliveira, Mario\",\"Person.identifier.orcid\":\"0000-0002-8371-8354\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | Silva Cunha, Pedro Viveiros Monteiro, André Coutinho Cruz, Madalena Malveiro, Paula Reis, João Pedro Portugal, Guilherme Dias, Ana Ferreira, Rui Cruz Oliveira, Mario |
| datacite.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2022-02-25T16:09:53Z |
| datacite.date.embargoed.fl_str_mv | 2022-02-25T16:09:53Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| datacite.titles.title.fl_str_mv | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | Silva Cunha, Pedro Viveiros Monteiro, André Coutinho Cruz, Madalena Malveiro, Paula Reis, João Pedro Portugal, Guilherme Dias, Ana Ferreira, Rui Cruz Oliveira, Mario |
| dc.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2022-02-25T16:09:53Z |
| dc.date.embargoed.fl_str_mv | 2022-02-25T16:09:53Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/51519 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | MDPI |
| dc.rights.cclincense.fl_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| dc.title.fl_str_mv | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | 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. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/3bbeac54-26aa-4a74-ae2d-0c9eea78aac6/download |
| id | ul_a1c66b3f93772ffbb855fdf7bf7b6b49 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/51519 |
| inst_facet_str | urn:organizationAcronym:ul{{{_:::_}}}Universidade de Lisboa |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/51519 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | Silva Cunha, Pedro Viveiros Monteiro, André Coutinho Cruz, Madalena Malveiro, Paula Reis, João Pedro Portugal, Guilherme Dias, Ana Ferreira, Rui Cruz Oliveira, Mario Oliveira, Mario https://www.ciencia-id.pt/2312-2190-19B2 2312-2190-19B2 http://orcid.org/0000-0002-8371-8354 0000-0002-8371-8354 |
| publishDate | 2022 |
| publisher.none.fl_str_mv | MDPI |
| repo_facet_str | urn:repositoryAcronym:ul{{{_:::_}}}Repositório da Universidade de Lisboa |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engMDPIpt_PTAtrial 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.application/pdfpt_PTNon-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillationSilva Cunha, PedroViveiros Monteiro, AndréCoutinho Cruz, MadalenaMalveiro, PaulaReis, João PedroPortugal, GuilhermeDias, AnaFerreira, Rui CruzPersonalOliveira, MarioDSpacehttp://dspace.org/items/81e0b444-8832-47a8-a911-2f89eb33545dDSpacehttp://dspace.org/items/81e0b444-8832-47a8-a911-2f89eb33545dMartins OliveiraMario JoaoCiência IDhttps://www.ciencia-id.pt2312-2190-19B2ORCIDhttp://orcid.org0000-0002-8371-8354HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@ulisboa.ptrepositorio@ulisboa.ptDOIIsPartOf10.3390/geriatrics70100202022-02-25T16:09:53Z20222022-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/51519http://purl.org/coar/access_right/c_abf2open accessAnticoagulation unitAtrial fibrillationNon-vitamin K oral anticoagulants547338 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal article2022http://creativecommons.org/licenses/by/4.0/http://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/3bbeac54-26aa-4a74-ae2d-0c9eea78aac6/downloadGeriatrics71 |
| spellingShingle | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation Silva Cunha, Pedro Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| status | SINGLETON |
| subject.fl_str_mv | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| title | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| title_full | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| title_fullStr | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| title_full_unstemmed | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| title_short | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| title_sort | Non-vitamin K oral anticoagulants assessment in high risk of bleeding patients with non-valvular atrial fibrillation |
| topic | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| topic_facet | Anticoagulation unit Atrial fibrillation Non-vitamin K oral anticoagulants |
| url | http://hdl.handle.net/10451/51519 |
| visible | 1 |