| 1 | Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry显示文摘Objectives To investigate the rate of anticoagulant use,the reasons for not prescribing anticoagulant,and the factors associated with non-prescription of anticoagulant in older Thai adults with non-valvular atrial fibrillation.Methods A multicenter registry of patients with non-valvular atrial fibrillation was conducted during 2014 to 2017 in Thailand.Demographic,medical history,antithrombotic medication,non-antithrombotic medication,and laboratory data were collected and analyzed.Data were compared between the older adult (≥ 65 years) and younger adult (< 65 years) groups.The reasons why anticoagulant was not prescribed were collected,and predictive factors were identified.Results A total of 3218 patients (1873 males) with an average age of 67.3 ± 11.3 years were included.Almost two-thirds (61.0%) of patients were in the older adult group.Anticoagulant was prescribed in 2422 patients (75.3%): 81.4% in the older adult group and 65.7% in the younger adult group.The three main reasons for not prescribing anticoagulant were already taking antiplatelets,patient refusal,and bleeding risk.These reasons were more common in older adults as compared to younger adults.Multivariate analysis revealed current use of antiplatelets to be the most important factor that predict the non-prescription of anticoagulant in older population.Conclusions The prevalence of anticoagulant prescription among older Thai adults with atrial fibrillation is 81.4%.Taking antiplatelet drugs was found to be the strongest reason that predicts the non-prescription of anticoagulant in this patient population.A guideline should be developed to optimize the use of anticoagulant and antiplatelet in older adults. | Rungroj Krittayaphong Arintaya Phrommintikul Pornchai Ngamjanyaporn Khanchai Siriwattana Wiwat Kanjanarutjawiwat Thoranis Chantrarat Roj Rojjarekampai Pontawee Kaewcomdee Patthrapon Sonkhammee | 2019 | Journal of Geriatric Cardiology2019，16，3： | 3 |
| 2 | History of major bleeding predicts risk of clinical outcome of patients with atrial fibrillation: results from the COOL-AF registry显示文摘Objective To compare clinical outcomes between patients with and without history of major bleeding according to types of antithrombotic medications in patients with non-valvular atrial fibrillation(NVAF). Methods We conducted a multicenter registry of patients with NVAF during 2014 to 2017 in Thailand. The following data were collected: demographic data, type of NVAF, medical illness, components of CHA2DS2-VASc and HAS-BLED scores, history of bleeding and severity, investigations, and antithrombotic medications. Clinical outcomes were death, bleeding, and ischemic stroke/transient ischemic attack(TIA). Results There were a total of 3218 patients. The average age was 67.3 ± 11.3 years, and 58.3% were men. Sixty-nine patients(2.14%) had a history of major bleeding. Antithrombotic use was, as follows: 2126 patients(75.3%) received oral anticoagulant(OAC) alone, 555(17.2%) received antiplatelet alone, 298(9.3%) received both, and 239(7.4%) received neither. During follow-up, 9.9% had major adverse outcomes, including death(5.9%), ischemic stroke/TIA(2.5%), and major bleeding(4.0%). There were no significant differences in the types of antithrombotic medications between patients with and without history of major bleeding. Multivariate analysis revealed old age, low body mass index, hypertension, diabetes, heart failure, and history of major bleeding to be independently associated with major adverse outcome. Adverse events significantly increased in patients with OAC plus antiplatelet. Conclusions History of major bleeding was identified as a factor that significantly affects clinical outcome. Inappropriate use of OAC plus antiplatelet should be avoided. Special caution should be made in this high-risk patients. | Rungroj Krittayaphong Arjbordin Winijkul Wattana Wongtheptien Chaiyasith Wongvipaporn Treechada Wisaratapong Rapeephon Kunjara-Na-Ayudhya Smonporn Boonyaratvej Pontawee Kaewcomdee Ahthit Yindeengam | 2020 | Journal of Geriatric Cardiology2020，17，4： | 0 |
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