title: Antithrombotic treatment and characteristics of elderly patients with non-valvular atrial fibrillation hospitalized at Internal Medicine departments. NONAVASC registry.
abstract: The prevalence of non-valvular atrial fibrillation (NVAF) increases with the patient's age and is associated with high morbi-mortality rates. The main goal of this study was to describe the characteristics of hospitalized elderly patients with NVAF and to identify the clinical and functional factors which determine the use of different antithrombotic strategies.
  
  
  METHODS
  Observational, prospective, multicentre study carried out on patients with NVAF over the age of 75, who had been admitted for any medical condition to Internal Medicine departments.
  
  
  RESULTS
  We evaluated 804 patients with a mean age of 85 years (range 75-101), of which 53.9% were females. The prevalence of risk factors and cardiovascular disease was high: hypertension (87.6%), heart failure (65.4%), ischemic cardiomyopathy (24.4%), cerebrovascular disease (22.4%) and chronic kidney disease (45%). Among those cases with previous diagnoses of NVAF, antithrombotic treatment was prescribed in 86.2% of patients: anticoagulants (59.7%), antiplatelet medication (17.8%) and double therapy (8.7%). The factors associated with the use of antithrombotic treatment were history of acute coronary syndrome and atrial fibrillation progression longer than one year. Older age, atrial fibrillation for less than one year, higher HAS-BLED scores and severe cognitive impairment were associated with the use of anti-platelet drugs. Permanent atrial fibrillation favoured the use of anticoagulants.
  
  
  CONCLUSIONS
  Hospitalized patients older than 75 years old with NVAF showed numerous comorbidities. The percentage of anticoagulation was small and 18% received only anti-platelet therapy. The patient's age, atrial fibrillation's progression time and the severity of the cognitive impairment influenced this therapy choice.
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de La Princesa. Madrid, España. Electronic address: a.gullon.ojesto@hotmail.com.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gullón
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de La Princesa. Madrid, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Suárez
authors.affiliation: Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Díez-Manglano
authors.affiliation: Servicio de Medicina Interna, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Servicio de Medicina Interna, Hospital Vega Baja, Orihuela, Alicante. España.
authors.forename: José María
authors.initials: JM
authors.lastname: Cepeda
authors.affiliation: Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pose
authors.affiliation: Servicio de Medicina Interna, Hospital Universitari Clínic Barcelona, Barcelona. España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Camafort
authors.affiliation: Servicio de Medicina Interna, Fundación Hospital Calahorra, Calahorra, La Rioja, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castiella
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario de la Ribera, Alzira, Valencia, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Rovira
authors.affiliation: Servicio de Medicina Interna, Hospital Carlos III, Madrid, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Mostaza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000188:drug therapy*; D000066491:Clinical Decision-Making; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007388:Internal Medicine; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012042:Registries; D013030:Spain
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Ancianos; Antithrombotic treatment; Elderly; Fibrilación auricular no valvular; Non-valvular atrial fibrillation; Tratamiento antitrombótico