A Cross-sectional Survey on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Elderly Patients with Non-Valvular Atrial Fibrillation
10.3760/cma.j.issn.0254-9026.2025.04.009
- VernacularTitle:高龄非瓣膜性房颤患者服用非维生素K拮抗剂口服抗凝药情况的单中心横断面调查
- Author:
Yifan NA
1
;
Junpeng LIU
;
Yatong ZHANG
;
Zinan ZHAO
;
Tianqi ZHANG
;
Yuhao WAN
;
Min ZENG
;
Ning SUN
;
Cheng WU
;
Jun WANG
;
Fang WANG
;
Jiefu YANG
Author Information
1. 北京医院药学部 药物临床风险与个体化应用评价北京市重点实验室 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Publication Type:Journal Article
- Keywords:
Atrial fibrillation;
Elderly;
Anticoagulation;
Polypharmacy
- From:
Chinese Journal of Geriatrics
2025;44(4):458-464
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the use of non-vitamin K antagonist oral anticoagulants(NOACs)and their associated comorbidities in patients aged 80 years and older with non-valvular atrial fibrillation(NVAF), as well as to understand the challenges faced by elderly patients receiving NOAC therapy.Methods:We retrospectively enrolled elderly patients(≥80 years old)with NVAF who were treated with NOACs at a hospital in Beijing from January 2018 to August 2023.Patients were categorized into two age groups: 80-89 years and ≥90 years.We collected baseline data, including demographic characteristics, details of atrial fibrillation, comorbidities, laboratory test results, and medication combinations, for descriptive statistical analysis and intergroup comparisons.Results:A total of 695 elderly patients with NVAF receiving NOACs were included in the study, with a median age of 84 years.Among these patients, there were 328 males(47.19%, 328/695)and 422 cases of paroxysmal atrial fibrillation(60.72%, 422/695).The age group of 80-89 years comprised 640 cases(92.09%, 640/695), while the group aged 90 years and above included 55 cases(7.91%, 55/695).The use of NOACs in patients aged 90 and older exhibited an increasing trend over the years.Inter-group comparisons indicated that the ≥90 years group had lower body mass index, longer hospital stays, increased bedridden time, poorer renal function, lower levels of albumin and hemoglobin, and higher D-dimer levels.Inappropriate dosing of DOACs occurred in 49.64%(345/695)of cases, with 90.72%(313/345)receiving doses lower than recommended.Lower-than-recommended doses were more prevalent in the ≥90 years group, while higher-than-recommended doses were more common in the 80-89 years group.Polypharmacy was noted in 61.29%(426/695)of patients.The concurrent use of antiplatelet drugs, rhythm control medications, and ventricular rate control drugs was observed in 12.52%(87/695), 19.57%(136/695), and 54.53%(379/695)of patients, respectively, with no significant differences between groups.Conclusions:Inappropriate dosing and polypharmacy are prevalent issues among elderly NVAF patients.Therefore, it is essential to enhance multidisciplinary collaboration to optimize anticoagulation treatment strategies.
