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Therapeutic management in ambulatory elderly patients with atrial fibrillation: The S.AGES cohort

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The journal of nutrition, health & aging

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.

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Author information

Authors and Affiliations

  1. Assistance Publique–Hôpitaux de Paris, Hôpital Broca, Service de Gériatrie, Paris, France

    O. Hanon, J. S. Vidal & G. Pisica-Donose

  2. Université Paris Descartes, Sorbonne Paris Cité, Equipe d’Accueil, 4468, Paris, France

    O. Hanon, J. S. Vidal, G. Pisica-Donose & F. Forette

  3. ORPEA/ CLINEA, Puteaux, France

    L. Benattar-Zibi

  4. CHU Limoges, Service de Rhumatologie, Limoges, France

    P. Bertin

  5. CHRU de Nantes — Pôle de soins gériatriques — Hôpital Saint Jacques, 44000, Nantes, France

    G. Berrut

  6. INSERM U 669, Université Paris-Sud, Faculté de médecine Paris-Sud, Département de Psychiatrie, Hôpital de Bicêtre, Assistance Publique–Hôpitaux de Paris, 94230, Le Kremlin Bicêtre, France

    E. Corruble

  7. Exploration Fonctionnelles Cardiovasculaires; Hôpital Louis Pradel; Hospices Civils de Lyon, Bron, France

    G. Derumeaux

  8. INSERM U 669, Université Paris-Sud, Faculté de médecine Paris-Sud Département de Biostatistiques; Assistance Publique Hôpitaux de Paris, Hôpital Paul Brousse, le Kremlin Bicêtre, France

    B. Falissard

  9. Fondation Nationale de Gérontologie, Paris, France

    F. Forette

  10. CHU Lille, Neurologie — Hôpital Roger Salengro, 59000, Lille, France

    F. Pasquier

  11. Service d’Endocrinologie, Diabète, Maladies de la Nutrition (Pôle NUDE), Hôpitaux Universitaires de Strasbourg et Centre européen d’étude du Diabète (CeeD), Université de Strasbourg, Strasbourg, France

    M. Pinget

  12. Département médecine générale, Faculté de médecine Paris-Sud, Université Paris-Sud, Le Kremlin-Bicêtre, France

    R. Ourabah

  13. Département de Pharmacologie, Faculté de médecine Paris-Sud, Université Paris-Sud; Assistance Publique Hôpitaux de Paris, Hôpital Bicêtre, le Kremlin Bicêtre, France

    L. Becquemont

  14. AP-HP, Hôpital européen Georges Pompidou, Service de Gériatrie, Paris, France

    N. Danchin

  15. Hôpital Broca, Service de Gérontologie, 54-56 rue Pascal, Paris, 75013, France

    O. Hanon

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  1. O. Hanon
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  2. J. S. Vidal
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  3. G. Pisica-Donose
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  4. L. Benattar-Zibi
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  5. P. Bertin
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  7. E. Corruble
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  8. G. Derumeaux
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  9. B. Falissard
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  14. L. Becquemont
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  15. N. Danchin
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Consortia

The S.AGES Investigators

Corresponding author

Correspondence to O. Hanon.

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Hanon, O., Vidal, J.S., Pisica-Donose, G. et al. Therapeutic management in ambulatory elderly patients with atrial fibrillation: The S.AGES cohort. J Nutr Health Aging 19, 219–227 (2015). https://doi.org/10.1007/s12603-015-0444-9

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  • DOI: https://doi.org/10.1007/s12603-015-0444-9

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