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Vol 19 (2024): Continuous Publishing
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Published online: 2023-11-16

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Antithrombotic therapy in elderly patients with atrial fibrillation: an analysis of non-treatment predisposing factors - results from the Polish Atrial Fibrillation (POL-AF) registry.

Agnieszka Ciba-Stemplewska12, Iwona Gorczyca-Głowacka3, Olga Jelonek34, Beata Uziębło-Życzkowska5, Małgorzata Maciorowska5, Maciej Wójcik6, Robert Błaszczyk6, Agnieszka Kapłon-Cieślicka7, Monika Gawałko789, Renata Rajtar-Salwa10, Tomasz Tokarek1112, Jacek Bil13, Michał Wojewódzki13, Anna Szpotowicz14, Małgorzata Krzciuk14, Janusz Bednarski1516, Elwira Bakuła-Ostalska15, Anna Tomaszuk-Kazberuk17, Anna Szyszkowska17, Marcin Wełnicki18, Artur Mamcarz18, Beata Wożakowska-Kapłon34
DOI: 10.5603/fc.97374


Introduction. The elderly age is associated with numerous comorbidities. Benefits of antithrombotic treatment regarding the prevention of stroke in patients aged ≥ 75 were demonstrated in most studies. The studies were undertaken due to elderly patients being underrepresented in randomized controlled trials. The aim of this study was to assess the prevalence of oral anticoagulant (OAC) therapy in patients aged ≥ 75 and to identify factors that predispose patients in this group for discontinuation of treatment.

Methods. The study was based on the multicenter prospective Polish Atrial Fibrillation (POL-AF) registry including patients from 10 cardiology centres in Poland. Recruitment lasted from 1 January 2019 to 1 December 2019. Included and analyzed in the study were patients aged ≥ 75 years.

Results. The study group consisted of 1731 patients, with 1563 (90.3%) patients receiving OACs, 71 (4.1%) patients receiving antiplatelets drug, 54 (3.1%) patients receiving low molecular weight heparin, and 43 (2.5%) patients not receiving any stroke prevention. The mean age was 82.2 (5.0) years. Univariable logistic regression models were developed for the choice of OAC versus no treatment. On this basis, specific predictors for the choice of OAC treatment were selected for including in the multivariable model. Independent predictors of no OAC prescription were: anaemia (odds ratio [OR] 0.14, 95% CI: 0.06–0.35, p < 0.001), history of bleeding (OR 0.26, 95% CI: 0.14–0.5, p < 0.001), renal dysfunction (OR 0.42, 95% CI 0.27–0.67, p < 0.001), cancer (OR 0.54, 95% CI: 0.3–0.97, p = 0.04), and age (OR 0.79, 95% CI 0.67–0.94, p = 0.006).

Conclusions. Most elderly AF patients received OACs. The factors predisposing to non-use of OACs in these patients included conditions which significantly increased the risk of bleeding complications.

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