title: Oral anticoagulation in octogenarians with atrial fibrillation.
abstract: BACKGROUND
  Vitamin K antagonists (VKAs) are still largely employed, even in nonvalvular atrial fibrillation (AF). Our aim was to study the clinical profile of octogenarians treated with oral anticoagulation and to study the effect of age on the quality of VKAs anticoagulation.
  
  
  METHODS
  Data are from a prospective national registry in an adult Spanish population of nonvalvular AF. We included 1637 patients who had been receiving VKAs for at least 6months before enrolment.
  
  
  RESULTS
  Mean age was 73.8±9.4years. Patients aged >80years (N=429) had a high risk profile with higher risk of stroke and bleeding than younger patients; CHA2DS2-VASc (Cardiac failure, Hypertension, Age>74, Diabetes, Stroke, Vascular disease, Age 65-74years, and Sex category) 4.5±1.3 vs. 3.5±1.6, p<0.001, HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (>64years), Drugs/alcohol concomitantly) 2.4±0.9 vs. 1.9±1.1, p<0.001. Creatinine clearance was lower in octogenarians than in younger patients (54.3±16.1ml/min vs. 69.5±23.7ml/min, p<0.001) and severe renal disease with creatinine clearance <30ml/min was more frequent in octogenarians (5.2% vs. 2.2%, p<0.001). In patients treated with VKAs (N=1637), the international normalized ratio values of the 6months previous to enrollment were similar in all age quartiles, as was the time in the therapeutic range.
  
  
  CONCLUSIONS
  In this large registry octogenarians with nonvalvular AF had high risk of stroke and bleeding and frequent renal disease. VKAs anticoagulation quality was similar in octogenarians and in younger patients.
authors.affiliation: Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: González Saldivar
authors.initials: GS
authors.lastname: Hugo
authors.affiliation: Facultad de Medicina Campus Xalapa. Universidad Veracruzana, Xalapa, Veracruz, Mexico.
authors.forename: Lourdes M
authors.initials: LM
authors.lastname: Figueiras-Graillet
authors.affiliation: Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Anguita
authors.affiliation: Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Marín
authors.affiliation: Department of Cardiology, Hospital San Juan de Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.affiliation: Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Roldán
authors.affiliation: Department of Cardiology, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Instituto Universitario de Ciencias de la Salud e INIBIC, Universidad de A Coruña, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Muñiz
authors.affiliation: Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Universidad Complutense, Madrid, Spain; Universidad Europea, Madrid, Spain. Electronic address: mmselles@secardiologia.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Martínez-Sellés
mesh_terms: D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Age; Atrial fibrillation; Octogenarians; Time in therapeutic range; Vitamin K antagonists