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Stroke prevention in elderly patients with non‐valvular atrial fibrillation in the BALKAN‐AF survey
Author(s) -
Potpara Tatjana S.,
Simovic Stefan,
Pavlovic Nikola,
Nedeljkovic Milan,
Paparisto Vilma,
Music Ljilja,
Goshev Evgenii,
Loncar Daniela,
Popescu Raluca,
Manola Sime,
Kusljugic Zumreta,
Trendafilova Elina,
Dan GheorgheAndrei,
Lip Gregory Y. H.
Publication year - 2020
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13200
Subject(s) - medicine , atrial fibrillation , odds ratio , guideline , stroke (engine) , montenegro , mechanical engineering , pathology , engineering , ethnology , history
Background Atrial fibrillation (AF) is common amongst the elderly, but this group tends to be suboptimally treated. Limited data are available on the stroke prevention strategies in the elderly, especially in the Balkan region. Aim We investigated the use of oral anticoagulant therapy (OAC) amongst elderly AF patients in clinical practice in the Balkan region. Method A 12‐week prospective snapshot survey (2014‐2015) of consecutive non‐valvular AF patients was conducted in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Montenegro, Romania and Serbia. Data were collected via an electronic case report form. Results Of 2671 patients, 418 (15.6%) were ≥80 years old. Overall, OAC was used in 1965 patients (73.6%). Compared with younger patients, the elderly (age ≥ 80) had a higher mean CHA 2 DS 2 ‐VASc score (3.22 ± 1.71 vs 4.89 ± 1.35, P < .001) and more often a HAS‐BLED score of ≥3 (n = 198 [47.0%] vs n = 625 [27.3%], P < .001), but were less likely to receive OAC (n = 269 [64.4%] vs n = 1696 [75.3%], odds ratio [OR] 0.91; 95%CI 0.86‐0.97, P = .003). There was no significant association between OAC use and mean CHA 2 DS 2 ‐VASc (OR 0.86; 95%CI 0.75‐1.00, P = .053) or HAS‐BLED score (OR 1.21; 95%CI 0.81‐1.81, P = .349) in the elderly. Conclusion In the BALKAN‐AF Survey, elderly AF patients were less likely to receive the guideline‐adherent treatment despite their less favourable risk profile. Since OAC nonuse among the elderly was not associated with increased HAS‐BLED score, factors other than patients’ risk profile could influence the implementation of guideline‐adherent treatment for thromboprophylaxis in the elderly AF patients.