Anticoagulation status of elderly patients with non-valvular atrial fibrillation in secondary and tertiary hospitals of Chongqing

Abstract

Objective To investigate the current status of anticoagulation therapy for the elderly patients aged 75 years or over with non-valvular atrial fibrillation in secondary and tertiary hospitals in Chongqing. Methods A total of 3 821 patients aged 75 years old or over with non-valvular atrial fibrillation from 19 hospitals (6 secondary hospitals and 13 tertiary hospitals) in Chongqing between January 1, 2018 and December 31, 2018 were enrolled in this study. The clinical data of patients were collected by electronic medical record system. Their baseline data, scores of CHA2DS2-VASc and HAS-BLED, anticoagulant rate and anticoagulant drugs were compared and analyzed. Results All the patients had their CHA2DS2-VASc score ≥2, and those with HAS-BLED score ≥3 accounted for 25.0%. The overall anticoagulant rate was 36.2%. And of these patients, 10.8% and 25.4% were treated with new oral anticoagulants (NOAC) and warfarin respectively, 43.3% were treated with antiplatelet alone without anticoagulant, and 20.5% were not treated with any antithrombotic therapy. The prescription rate of NOAC and warfarin in these patients was much lower in secondary hospitals than tertiary hospitals (5.3% vs 13.0%, P<0.001; 16.1% vs 28.9%, P<0.001). Conclusion Among the inpatients in the secondary and tertiary hospitals of Chongqing, those aged 75 years or over with non-valvular atrial fibrillation have higher risk of embolism, lower risk of bleeding, but lower overall anticoagulation rate, especially in the secondary hospital when compared with the tertiary hospital. It is necessary to take positive measures to strengthen the training of relevant doctors in order to effectively improve the anticoagulation rate in these patients.

Keywords

• aged
• non-valvular atrial fibrillation
• anticoagulation therapy
• new oral anticoagulants
• warfarin
• current situation investigation