Abstract

HERNANDEZ, Verónica; SAAVEDRA, Jesús; MAZOTERAS, Virginia  and  LOPEZ, María T.. Underuse of oral anticoagulation in octogenarian patient with atrial fibrillation: a perspective from real clinical practice. Rev. Colomb. Cardiol. [online]. 2015, vol.22, n.5, pp.231-234. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.06.003.

Introduction and objectives: Atrial fibrillation is the most common arrhythmia in elderly patients. Anticoagulation decision in this group can be difficult. We wanted to study the management of oral anticoagulation in very elderly patients with atrial fibrillation in clinical practice and the factors associated with the decision to anticoagulation. Methods: We studied all patients older than 80 years with known atrial fibrillation treated at the geriatric consultation from June to December 2013. Results: We studied 90 patients with a mean age of 85.6 years. The mean score of CHA2DS2-VASc was 4.7 and the mean of HAS-BLED was 2. 53% were anticoagulated. Out of anticoagulated patients, 96% were taking Acenocumarol and 4% new anticoagulants. In multivariate analysis, age and history of dementia was associated with the decision not to use anticoagulants. Conclusions: Our results suggest that a high percentage of very elderly patients with atrial fibrillation are without anticoagulation. The history of dementia and age outweigh the CHAD2DS2-Vasc and HAS-BLED score on deciding to anticoagulate.

Keywords : Atrial fibrillation; Embolization; Haemorrhage; Anticoagulation.

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