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老年房颤患者口服抗凝药的类型和剂量以及抗凝治疗的依从性:ESPARTA研究

Type and doses of oral anticoagulants and adherence to anticoagulant treatment in elderly patients with atrial fibrillation: the ESPARTA study.

作者信息

Mostaza Jose María, Suárez Fernández Carmen, Castilla Guerra Luis, Suriñach Josep Maria, Tamarit Juan José, Diaz Diaz José Luis, García Polo Iluminada, Santamaria Esther Francia, Fidalgo Fernández María Angeles, de la Guerra Acebal Carla, Dávila Ramos Meliton Francisco, Ràfols Carles

机构信息

Internal Medicine Service, Hospital Carlos III, Madrid 28029, Spain.

Internal Medicine Service, Hospital Universitario de La Princesa, Madrid 28006, Spain.

出版信息

J Comp Eff Res. 2018 Mar;7(3):223-232. doi: 10.2217/cer-2017-0034. Epub 2018 Feb 21.

Abstract

AIM

To analyze the use of oral anticoagulants in elderly patients with atrial fibrillation in clinical practice.

PATIENTS & METHODS: Cross-sectional and multicenter study performed in atrial fibrillation patients ≥75 years treated with oral anticoagulants ≥3 months.

RESULTS

837 patients (83.0 ± 5.0 years; CHADS-VASc 5.0 ± 1.4; HAS-BLED 2.1 ± 0.9; 70.8% vitamin K antagonists; 29.2% direct oral anticoagulants [DOACs]) were included. Poor adherence was observed in 27.9% of patients. Higher scores in the Pfeiffer's test and FRAIL scale were associated with poorer adherence. Among patients treated with DOACs, 62.3% received the lower doses. Having high CHADS score and being older were associated with the use of low doses.

CONCLUSION

28% of patients had a poor adherence to anticoagulant treatment. 62% of patients were treated with the lower doses of DOACs.

摘要

目的

分析老年房颤患者在临床实践中口服抗凝剂的使用情况。

患者与方法

对年龄≥75岁且接受口服抗凝剂治疗≥3个月的房颤患者进行横断面多中心研究。

结果

纳入837例患者(年龄83.0±5.0岁;CHADS-VASc评分5.0±1.4;HAS-BLED评分2.1±0.9;70.8%使用维生素K拮抗剂;29.2%使用直接口服抗凝剂[DOACs])。27.9%的患者存在依从性差的情况。Pfeiffer测试和衰弱量表得分较高与依从性较差相关。在使用DOACs治疗的患者中,62.3%使用较低剂量。CHADS评分高和年龄较大与低剂量使用相关。

结论

28%的患者抗凝治疗依从性差。62%的患者接受较低剂量的DOACs治疗。

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