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Oral anticoagulation in patients aged 75 years or older with chronic non-valvar atrial fibrillation: effectiveness and safety in daily clinical practice
  1. M Ruiz Ortiz,
  2. E Romo Peñas,
  3. M F Franco Zapata,
  4. D Mesa Rubio,
  5. M Anguita Sánchez,
  6. A López Granados,
  7. J M Arizón del Prado,
  8. F Vallés Belsué
  1. Department of Cardiology, Hospital Reina Sofía, Cordoba, Spain
  1. Correspondence to:
    Dr M Ruiz Ortiz
    C/Huerta del Recuero 1, portal 7-3°2, 14011 Cordoba, Spain;

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Although American College of Cardiology/American Heart Association/European Society of Cardiology clinical practice guidelines1 recommend oral anticoagulation for patients aged 75 years or older with non-valvar atrial fibrillation (NVAF) and without contraindication to this treatment, underutilisation has often been reported.2 Moreover, this population has been underrepresented in clinical trials—the only one that included a high proportion of elderly patients3 had equivocal results: a reduction of embolic events, but an increase in severe bleeding, especially intracranial, that offset the benefit obtained. We planned a prospective observational cohort study with the following objectives: to describe cardioembolic risk factors and contraindications to anticoagulants in our population of elderly patients; to manage oral anticoagulation prescription in this group by trying to follow the guidelines; and to evaluate whether oral anticoagulation in our outpatient cardiology clinic is effective and safe to lessen thromboembolic events in elderly patients with NVAF. We have previously reported the usefulness of a prospective protocol in this setting to increase oral anticoagulation prescription.4 This work describes basal and follow up data of the subgroup of patients aged 75 years and older. This protocol received the usual ethical approval for observational studies in our institution, and all patients gave informed consent. Patient selection criteria and methods have been described.4


From 1 February 2000 to 1 …

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  • This study has received a grant from the Mapfre Medicine Foundation.