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Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older

The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ≥80 year...

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Autores principales: Manckoundia, Patrick, Nuemi, Gilles, Hacquin, Arthur, Menu, Didier, Rosay, Clémentine, Vovelle, Jérémie, Nuss, Valentine, Baudin-Senegas, Camille, Barben, Jérémy, Putot, Alain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122810/
https://www.ncbi.nlm.nih.gov/pubmed/33922331
http://dx.doi.org/10.3390/ijerph18094443
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author Manckoundia, Patrick
Nuemi, Gilles
Hacquin, Arthur
Menu, Didier
Rosay, Clémentine
Vovelle, Jérémie
Nuss, Valentine
Baudin-Senegas, Camille
Barben, Jérémy
Putot, Alain
author_facet Manckoundia, Patrick
Nuemi, Gilles
Hacquin, Arthur
Menu, Didier
Rosay, Clémentine
Vovelle, Jérémie
Nuss, Valentine
Baudin-Senegas, Camille
Barben, Jérémy
Putot, Alain
author_sort Manckoundia, Patrick
collection PubMed
description The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ≥80 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for a medical prescription in September 2017. The demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs were compared in the DOAC group and VKA group. Of the 3190 included individuals, 1279 (40%) were prescribed DOACs and 1911 (60%) VKAs. Individuals taking VKAs were older than those taking DOACs (87.11 vs. 86.35 years). In the DOAC group, there were more women (51.92% vs. 48.25%) (p = 0.043), less RCD (89.60% vs. 92.73%) (p = 0.002), less VTE (1.80% vs. 6.59%), less severe heart failure (58.09% vs. 67.87%), less severe hypertension (18.22% vs. 23.60%), less severe kidney diseases (1.49% vs. 3.82%), and fewer drugs per prescription (6.15 vs. 6.66) (p < 0.01 for all). The DOAC group were also less likely to be taking angiotensin receptor blockers (10.79% vs. 13.97%), furosemide (40.81% vs. 49.66%) or digoxin (10.32% vs. 13.66%) than the VKA group (p = 0.009, p < 0.001, and p = 0.005). DOACs were less prescribed than VKAs. Individuals taking VKAs were older and had more severe comorbidities and more drugs per prescription than those taking DOACs.
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spelling pubmed-81228102021-05-16 Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older Manckoundia, Patrick Nuemi, Gilles Hacquin, Arthur Menu, Didier Rosay, Clémentine Vovelle, Jérémie Nuss, Valentine Baudin-Senegas, Camille Barben, Jérémy Putot, Alain Int J Environ Res Public Health Article The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ≥80 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for a medical prescription in September 2017. The demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs were compared in the DOAC group and VKA group. Of the 3190 included individuals, 1279 (40%) were prescribed DOACs and 1911 (60%) VKAs. Individuals taking VKAs were older than those taking DOACs (87.11 vs. 86.35 years). In the DOAC group, there were more women (51.92% vs. 48.25%) (p = 0.043), less RCD (89.60% vs. 92.73%) (p = 0.002), less VTE (1.80% vs. 6.59%), less severe heart failure (58.09% vs. 67.87%), less severe hypertension (18.22% vs. 23.60%), less severe kidney diseases (1.49% vs. 3.82%), and fewer drugs per prescription (6.15 vs. 6.66) (p < 0.01 for all). The DOAC group were also less likely to be taking angiotensin receptor blockers (10.79% vs. 13.97%), furosemide (40.81% vs. 49.66%) or digoxin (10.32% vs. 13.66%) than the VKA group (p = 0.009, p < 0.001, and p = 0.005). DOACs were less prescribed than VKAs. Individuals taking VKAs were older and had more severe comorbidities and more drugs per prescription than those taking DOACs. MDPI 2021-04-22 /pmc/articles/PMC8122810/ /pubmed/33922331 http://dx.doi.org/10.3390/ijerph18094443 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Manckoundia, Patrick
Nuemi, Gilles
Hacquin, Arthur
Menu, Didier
Rosay, Clémentine
Vovelle, Jérémie
Nuss, Valentine
Baudin-Senegas, Camille
Barben, Jérémy
Putot, Alain
Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title_full Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title_fullStr Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title_full_unstemmed Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title_short Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older
title_sort direct oral anticoagulants versus vitamin k antagonists in patients aged 80 years and older
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122810/
https://www.ncbi.nlm.nih.gov/pubmed/33922331
http://dx.doi.org/10.3390/ijerph18094443
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