Abstract:
BACKGROUND:Annually > 10% of patients with atrial fibrillation on oral anticoagulation undergo invasive procedures. Optimal peri-procedural management of anticoagulation, as judged by major bleeding and thromboembolic events, especially in the elderly, is still debated. METHODS:Procedures from 1442 patients were evaluated. Peri-procedural edoxaban management was guided only by the experience of the attending physician. The primary safety outcome was the rate of major bleeding. Secondary outcomes included the peri-procedural administration of edoxaban, other bleeding events, and the main efficacy outcome, a composite of acute coronary syndrome, non-hemorrhagic stroke, transient ischemic attack, systemic embolic events, deep vein thrombosis, pulmonary embolism, and mortality. RESULTS:Of the 1442 patients, 280 (19%) were < 65, 550 (38%) were 65-74, 514 (36%) 75-84, and 98 (7%) were 85 years old or older. With increasing age, comorbidities and risk scores were higher. Any bleeding complications were uncommon across all ages, ranging from 3.9% in patients < 65 to 4.1% in those 85 years or older; major bleeding rates in any age group were ≤ 0.6%. Interruption rates and duration increased with advancing age. Thromboembolic events were more common in the elderly, with all nine events occurring in those > 65, and seven in patients aged > 75 years. CONCLUSION:Despite increased bleeding risk factors in the elderly, bleeding rates were small and similar across all age groups. However, there was a trend toward more thromboembolic complications with advancing age. Further efforts to identify the optimal management to reduce ischemic complications are needed. TRIAL REGISTRATION:NCT# 02950168, October 31, 2016.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Unverdorben M,von Heymann C,Santamaria A,Saxena M,Vanassche T,Jin J,Laeis P,Wilkins R,Chen C,Colonna Pdoi
10.1186/s12872-020-01766-wsubject
Has Abstractpub_date
2020-12-01 00:00:00pages
504issue
1issn
1471-2261pii
10.1186/s12872-020-01766-wjournal_volume
20pub_type
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pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2018-09-10 00:00:00
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