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Titolo:
Oral anticoagulation in patients with atrial fibrillation: Adherence with guidelines in an elderly cohort
Autore:
White, RH; McBurnie, MA; Manolio, T; Furberg, CD; Gardin, JM; Kittner, SJ; Bovill, E; Knepper, L;
Indirizzi:
Univ Calif Davis, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CAUSA 95817 Davis, Sacramento, CA 95817 USA Cardiovasc Hlth Coordinating Ctr, Seattle, WA USA Cardiovasc Hlth Coordinating Ctr Seattle WA USA ing Ctr, Seattle, WA USA NHLBI, Bethesda, MD 20892 USA NHLBI Bethesda MD USA 20892NHLBI, Bethesda, MD 20892 USA Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA Wake Forest Univ Winston Salem NC USA ray Sch Med, Winston Salem, NC USA Univ Calif Irvine, Orange, CA 92668 USA Univ Calif Irvine Orange CA USA 92668 Calif Irvine, Orange, CA 92668 USA Univ Maryland, Sch Med, Baltimore, MD 21201 USA Univ Maryland Baltimore MD USA 21201 nd, Sch Med, Baltimore, MD 21201 USA Univ Vermont, Sch Med, Colchester, VT USA Univ Vermont Colchester VT USAUniv Vermont, Sch Med, Colchester, VT USA Univ Pittsburgh, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USAUniv Pittsburgh, Pittsburgh, PA USA
Titolo Testata:
AMERICAN JOURNAL OF MEDICINE
fascicolo: 2, volume: 106, anno: 1999,
pagine: 165 - 171
SICI:
0002-9343(199902)106:2<165:OAIPWA>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; CARDIOVASCULAR HEALTH; STROKE PREVENTION; FACTOR-VII; FACTOR-II; FACTOR-X; WARFARIN; THERAPY; MANAGEMENT; HOSPITALS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: White, RH Div Gen Med, Room 3107,PCC 2221 Stockton Blvd, Sacramento, CA 95817 USA Div Gen Med Room 3107,PCC 2221 Stockton Blvd Sacramento CA USA 95817
Citazione:
R.H. White et al., "Oral anticoagulation in patients with atrial fibrillation: Adherence with guidelines in an elderly cohort", AM J MED, 106(2), 1999, pp. 165-171

Abstract

PURPOSE: To determine adherence with practice guidelines in a population-based cohort of elderly persons aged 70 years or older with atrial fibrillation. SUBJECTS AND METHODS: This was a cross-sectional analysis of a subgroup ofparticipants in the Cardiovascular Health Study, a prospective observational study involving four communities in the United States. Subjects were participants with atrial fibrillation on electrocardiogram at one or more yearly examinations from 1993 to 1995. The outcome measure was self-reported use of warfarin in 1995. RESULTS: In 1995, 172 (4.1%) participants had atrial fibrillation togetherwith information regarding warfarin use and no preexisting indication for its use, Warfarin was used by 63 (37%) of these participants. Of the 109 participants not reporting warfarin use, 92 (84%) had at least one of the clinical risk factors (aside from age) associated with stroke in patients withatrial fibrillation. Among participants not taking warfarin, 47% were taking aspirin. Several characteristics were independently associated with warfarin use, including age [odds ratio (OR) = 0.6 per 5-year increment, 95% CI 0.5-0.9], a modified mini-mental examination score <85 points [OR = 0.3, 95% confidence interval (CI) 0.1-0.9], and among patients without prior stroke, female sex (OR = 0.5, 95% CI 0.2-1.0). CONCLUSIONS: Despite widely publicized practice guidelines to treat patients who have atrial fibrillation with warfarin, most participants who had atrial fibrillation were at high risk for stroke but were not treated with warfarin. More studies are needed to determine wily elderly patients with atrial fibrillation are not being treated with warfarin. Am J Med. 1999;106: 165-171. (C) 1999 by Excerpta Medica, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 13:25:25