title: Therapeutic management in ambulatory elderly patients with atrial fibrillation: the S.AGES cohort.
abstract: Few epidemiologic studies have specifically focused on very old community dwelling population with atrial fibrillation (AF). The objectives of the AF-S.AGES cohort were to describe real-life therapeutic management of non-institutionalized elderly patients with AF according to age groups, i.e., 65-79 and ≥ 80 and to determine the main factors associated with anticoagulant treatment in both groups.
  
  
  METHODS
  Observational study (N=1072) aged ≥ 65 years old, recruited by general practitioners. Characteristics of the sample were first evaluated in the overall sample and according to age (< 80 or ≥ 80 years) and to use of anticoagulant treatment at inclusion. Logistic models were used to analyze the determinants of anticoagulant prescription among age groups.
  
  
  RESULTS
  Mean age was 78.0 (SD=6.5) years and 42% were ≥ 80 years. Nineteen percent had paroxysmal AF, 15% persistent, 56% permanent and 10% unknown type, 77% were treated with vitamin K antagonists (VKA), 17% with antiplatelet therapy with no differences between age groups. Rate-control drugs were more frequently used than rhythm-control drugs (55% vs. 37%, p < 0.001). VKA use was associated with permanent AF, younger age and cancer in patients ≥ 80 years old and with permanent AF and preserved functional autonomy in patients < 80 years old. Hemorrhagic scores were independently associated with non-use of VKA whereas thromboembolic scores were not associated with VKA use.
  
  
  CONCLUSIONS
  In this elderly AF outpatient population, use of anticoagulant therapy was higher even after 80 years than in previous studies suggesting that recent international guidelines are better implemented in the elderly population.
authors: Professor O. Hanon, Hôpital Broca, Service de Gérontologie, 54-56 rue Pascal, Paris, 75013, France. E-mail: olivier.hanon@brc.aphp.fr, Tel: + 33 1 44 08 30 30, Fax: + 33 1 44 08 35 10.
authors: O
authors: O
authors: Hanon
authors: J S
authors: JS
authors: Vidal
authors: G
authors: G
authors: Pisica-Donose
authors: L
authors: L
authors: Benattar-Zibi
authors: P
authors: P
authors: Bertin
authors: G
authors: G
authors: Berrut
authors: E
authors: E
authors: Corruble
authors: G
authors: G
authors: Derumeaux
authors: B
authors: B
authors: Falissard
authors: F
authors: F
authors: Forette
authors: F
authors: F
authors: Pasquier
authors: M
authors: M
authors: Pinget
authors: R
authors: R
authors: Ourabah
authors: L
authors: L
authors: Becquemont
authors: N
authors: N
authors: Danchin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012306:Risk; D013923:Thromboembolism / Q000139:chemically induced / Q000175:diagnosis; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K
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