Reasons for and consequences of vitamin K antagonist discontinuation in very elderly patients with non-valvular atrial fibrillation

Journal of Thrombosis and Haemostasis

Volumn 14, Issue 11, 2016, Pages 2124-2131

  Bertozzo, G ^a   Zoppellaro, G ^a   Granziera, S ^a,b   Marigo, L ^a   Rossi, K ^a   Petruzzellis, F ^a   Perissinotto, E ^a   Manzato, E ^a   Nante, G ^a   Pengo, V ^a  

^a UNIVERSITY OF PADOVA   (Italy)

^b Department of Physical and Rehabilitation Medicine   (Italy)

Author keywords

atrial fibrillation; elderly; frail; patient compliance; warfarin suspension

Indexed keywords

ANTIVITAMIN K; LOW MOLECULAR WEIGHT HEPARIN; WARFARIN; ANTICOAGULANT AGENT; FIBRINOLYTIC AGENT; VITAMIN K GROUP;

AGED; ANTICOAGULATION; ARTICLE; ATRIAL FIBRILLATION; BLEEDING; COHORT ANALYSIS; COMORBIDITY; CONTROLLED STUDY; DRUG WITHDRAWAL; FEMALE; HIGH RISK PATIENT; HUMAN; INTERNATIONAL NORMALIZED RATIO; ISCHEMIA; LIFE EXPECTANCY; MAJOR CLINICAL STUDY; MALE; MORTALITY; MORTALITY RATE; NON VALVULAR ATRIAL FIBRILLATION; OBSERVATIONAL STUDY; PRIORITY JOURNAL; RISK FACTOR; SCORING SYSTEM; SINUS RHYTHM; THROMBOEMBOLISM; VASCULAR DISEASE; VERY ELDERLY; VISUAL ANALOG SCALE; ANTAGONISTS AND INHIBITORS; BLOOD; BLOOD CLOTTING; CEREBROVASCULAR ACCIDENT; FOLLOW UP; MULTIVARIATE ANALYSIS; PROPORTIONAL HAZARDS MODEL; TREATMENT OUTCOME;

AGED, 80 AND OVER; ANTICOAGULANTS; ATRIAL FIBRILLATION; BLOOD COAGULATION; FEMALE; FIBRINOLYTIC AGENTS; FOLLOW-UP STUDIES; HEMORRHAGE; HUMANS; MALE; MULTIVARIATE ANALYSIS; PROPORTIONAL HAZARDS MODELS; RISK FACTORS; STROKE; THROMBOEMBOLISM; TREATMENT OUTCOME; VASCULAR DISEASES; VITAMIN K; WARFARIN;

EID: 84995743835     PISSN: 15387933     EISSN: 15387836     Source Type: Journal    
DOI: 10.1111/jth.13427     Document Type: Article

References (43)

1. Wilke T, Groth A, Mueller S, Pfannkuche M, Verheyen F, Linder R, Maywald U, Bauersachs R, Breithardt G. Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients. Europace 2013; 15: 486–93.
2. Martinez C, Katholing A, Wallenhorst C, Granziera S, Cohen AT, Freedman SB. Increasing incidence of non-valvular atrial fibrillation in the UK from 2001 to 2013. Heart 2015; 101: 1748–54.
3. Marinigh R, Lip GYH, Fiotti N, Giansante C, Lane DA. Age as a risk factor for stroke in atrial fibrillation patients. J Am Coll Cardiol 2010; 56: 827–37.
4. Saposnik G, Black S. Stroke in the very elderly: hospital care, case fatality and disposition. Cerebrovasc Dis 2009; 27: 537–43.
5. Hart RG, Pearce LA, Aguilar MI. Adjusted-dose warfarin versus aspirin for preventing stroke in patients with atrial fibrillation. Ann Intern Med 2007; 147: 590–2.
6. Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007; 115: 2689–96.
7. Gage BF, Boechler M, Doggette AL, Fortune G, Flaker GC, Rich MW, Radford MJ. Adverse outcomes and predictors of underuse of antithrombotic therapy in medicare beneficiaries with chronic atrial fibrillation. Stroke 2000; 31: 822–7.
8. Ogilvie IM, Newton N, Welner SA, Cowell W, Lip GYH. Underuse of oral anticoagulants in atrial fibrillation: a systematic review. Am J Med 2010; 123: 638–45.e4.
9. Wang C, Yang Z, Wang C, Wang Y, Zhao X, Liu L, Wang DZ, Li H, Wang Y. Significant underuse of warfarin in patients with nonvalvular atrial fibrillation: results from the China national stroke registry. J Stroke Cerebrovasc Dis 2014; 23: 1157–63.
10. De Schryver ELLM, van Gijn J, Kappelle LJ, Koudstaal PJ, Algra A. Non-adherence to aspirin or oral anticoagulants in secondary prevention after ischaemic stroke. J Neurol 2005; 252: 1316–21.
11. O'Brien EC, Simon DN, Allen LA, Singer DE, Fonarow GC, Kowey PR, Thomas LE, Ezekowitz MD, Mahaffey KW, Chang P, Piccini JP, Peterson ED. Reasons for warfarin discontinuation in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J 2014; 168: 487–94.
12. Mant J, Hobbs FD, Fletcher K, Roalfe A, Fitzmaurice D, Lip GY, Murray E; BAFTA investigators; Midland Research Practices Network (MidReC). Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet 2007;370:493–503.
13. Patel AA, Reardon G, Nelson WW, Philpot T, Neidecker MV. Persistence of warfarin therapy for residents in long-term care who have atrial fibrillation. Clin Ther 2013; 35: 1794–804.
14. Patel MR, Hellkamp AS, Lokhnygina Y, Piccini JP, Zhang Z, Mohanty S, Singer DE, Hacke W, Breithardt G, Halperin JL, Hankey GJ, Becker RC, Nessel CC, Berkowitz SD, Califf RM, Fox KA, Mahaffey KW. Outcomes of discontinuing rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation. analysis from the ROCKET AF trial Rivaroxaban once-daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation. J Am Coll Cardiol 2013; 61: 651–8.
15. Granziera S, Bertozzo G, Pengo V, Marigo L, Denas G, Petruzzellis F, Rossi K, Infante T, Padayattil SJ, Perissinotto E, Manzato E, Nante G. To treat or not to treat very elderly naïve patients with atrial fibrillation with vitamin K antagonists (VKA): results from the VENPAF cohort. Intern Emerg Med 2015; 10: 795–804.
16. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, et al. 2013 ESH/ESC practice guidelines for the management of arterial hypertension. Blood Press 2014; 23: 3–16.
17. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2012; 14: 803–69.
18. Steiner T, Salman RA-S, Ntaios G. The European Stroke Organisation (ESO) guidelines. Int J Stroke 2014; 9: 838–9.
19. Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N, Deaton C, Escaned J, Hammes HP, Huikuri H, Marre M, Marx N, Mellbin L, Ostergren J, Patrono C, Seferovic P, Uva MS, Taskinen MR, Tendera M, Tuomilehto J, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur Heart J 2013; 34: 3035–87.
20. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, Hindricks G, Kirchhof P. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation – developed with the special contribution of the European Heart Rhythm Association. Eur Heart J 2012; 33: 2719–47.
21. Rosendaal FR, Cannegieter SC, van der Meer FJ, Briët E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993; 69: 236–9.
22. Fang MC, Go AS, Chang Y, Borowsky LH, Pomernacki NK, Udaltsova N, Singer DE. Warfarin discontinuation after starting warfarin for atrial fibrillation. Circ Cardiovasc Qual Outcomes 2010; 3: 624–31.
23. Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3: 692–4.
24. Gallagher AM, Rietbrock S, Plumb J, Van Staa TP. Initiation and persistence of warfarin or aspirin in patients with chronic atrial fibrillation in general practice: do the appropriate patients receive stroke prophylaxis? J Thromb Haemost 2008; 6: 1500–6.
25. Nieuwlaat R, Prins MH, Le Heuzey JY, Vardas PE, Aliot E, Santini M, Cobbe SM, Widdershoven JW, Baur LH, Lévy S, Crijns HJ. Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on atrial fibrillation. Eur Heart J 2008; 29: 1181–9.
26. Gomes T, Mamdani MM, Holbrook AM, Paterson JM, Juurlink DN. Persistence with therapy among patients treated with warfarin for atrial fibrillation. Arch Intern Med 2012; 172: 1687–9.
27. Martinez C, Katholing A, Wallenhorst C, Freedman SB. Therapy persistence in newly diagnosed non-valvular atrial fibrillation treated with warfarin or NOAC. A cohort study. Thromb Haemost 2016; 115: 31–9.
28. Beyer-Westendorf J, Ehlken B, Evers T. Real-world persistence and adherence to oral anticoagulation for stroke risk reduction in patients with atrial fibrillation. Europace. 2016; 18: 1150–7.
29. Nelson WW, Choi JC, Vanderpoel J, Damaraju CV, Wildgoose P, Fields LE, Schein JR. Impact of co-morbidities and patient characteristics on international ratio control over time in patients with nonvalvular atrial fibrillation. Am J Cardiol 2013; 112: 509–12.
30. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361: 1139–51.
31. White HD, Gruber M, Feyzi J, Kaatz S, Tse HF, Husted S, Albers GW. Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V. Arch Intern Med 2007; 167: 239–45.
32. Pengo V, Crippa L, Falanga A, Finazzi G, Marongiu F, Palareti G, Poli D, Testa S, Tiraferri E, Tosetto A, Tripodi A, Manotti C. Questions and answers on the use of dabigatran and perspectives on the use of other new oral anticoagulants in patients with atrial fibrillation. A consensus document of the Italian Federation of Thrombosis Centers (FCSA). Thromb Haemost 2011; 106: 868–76.
33. Zoppellaro G, Granziera S, Padayattil JS, Denas G, Bracco A, Iliceto S, Pengo V. Minimizing the risk of hemorrhagic stroke during anticoagulant therapy for atrial fibrillation. Expert Opin Drug Saf 2015; 14: 683–95.
34. Apostolakis S, Sullivan RM, Olshansky B, Lip GY. Factors affecting quality of anticoagulation control amongst atrial fibrillation patients on warfarin: the same-TT2R2 score. Chest 2013; 144: 1555–63.
35. Pengo V, Legnani C, Noventa F, Palareti G. Oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and risk of bleeding. A Multicenter Inception Cohort Study. Thromb Haemost 2001; 85: 418–22.
36. Lip GY, Andreotti F, Fauchier L, Huber K, Hylek E, Knight E, Lane D, Levi M, Marín F, Palareti G, Kirchhof P. Bleeding risk assessment and management in atrial fibrillation patients. Executive summary of a position document from the European Heart Rhythm Association (EHRA), endorsed by the European Society of Cardiology (ESC) Working Group on Thrombosis. Thromb Haemost 2011; 106: 997–1011.
37. Helgason CM, Do MA, Nutescu E. Warfarin in patients with stroke and reasons for discontinuation. J Stroke Cerebrovasc Dis 2004; 13: 70–3.
38. Arnsten JH, Gelfand JM, Singer DE. Determinants of compliance with anticoagulation: a case–control study. Am J Med 1997; 103: 11–17.
39. Hart RG, Pearce LA, Rothbart RM, McAnulty JH, Asinger RW, Halperin JL. Stroke with intermittent atrial fibrillation: incidence and predictors during aspirin therapy. Stroke Prevention in Atrial Fibrillation Investigators. J Am Coll Cardiol 2000; 35: 183–7.
40. You JJ, Singer DE, Howard PA, Lane DA, Eckman MH, Fang MC, Hylek EM, Schulman S, Go AS, Hughes M, Spencer FA, Manning WJ, Halperin JL, Lip GY. Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention Of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e531S–75S.
41. Staerk L, Lip GY, Olesen JB, Fosbøl EL, Pallisgaard JL, Bonde AN, Gundlund A, Lindhardt TB, Hansen ML, Torp-Pedersen C, Gislason GH. Stroke and recurrent haemorrhage associated with antithrombotic treatment after gastrointestinal bleeding in patients with atrial fibrillation: nationwide cohort study. BMJ 2015; 351: h5876.
42. Hecker J, Marten S, Keller L, Helmert S, Michalski F, Werth S, Sahin K, Tittl L, Beyer-Westendorf J. Effectiveness and safety of rivaroxaban therapy in daily-care patients with atrial fibrillation. Results from the Dresden NOAC Registry. Thromb Haemost 2016; 115: 939–49.
43. Beyer-Westendorf J, Förster K, Ebertz F, Gelbricht V, Schreier T, Göbelt M, Michalski F, Endig H, Sahin K, Tittl L, Weiss N. Drug persistence with rivaroxaban therapy in atrial fibrillation patients – results from the Dresden non-interventional oral anticoagulation registry. Europace 2015; 17: 530–8.