Author + information
- Stijn Van Vugta,b,
- Goaris Aartsa,b,
- Jeroen Jaspers Focksa,b,
- Lucie Bloema,b,
- Freek Verheugta,b and
- Marc Brouwera,b
Background: Polypharmacy has been associated with increased mortality and bleeding risk in elderly patients with atrial fibrillation (AF). However, the high prevalence of polypharmacy (>70%) in the elderly limits its discriminatory ability. Approaches on how to further differentiate risks in case of polypharmacy are eagerly awaited, and the number of drug classes used may serve as a proxy for increased frailty.
Methods: Prospective 3-year cohort of AF patients ≥ 75 years with polypharmacy (≥5 drugs) using a vitamin K antagonist monitored by the Thrombosis service (Nijmegen, Netherlands). The Anatomical Therapeutic Chemical (ATC) classification was used for classification of drugs into target organ systems. Outcomes (Table) were assessed in relation to the number of drug classes prescribed.
Results: Patients (n=1,443) had a median age of 81 years (IQR 78-85) and a median CHA2DS2-VASc score of 4 (IQR 4-6). Mean follow-up was 30 months (±10) and the median number of prescribed drug classes was 3 (IQR 2-4). Rates of major bleeding and all-cause mortality were higher with increasing numbers of drug classes (Table).
Conclusions: In an era of increasing life expectancy, with growing numbers of elderly patients with polypharmacy, the number of drug classes used seems a promising tool to identify patients at higher risk of bleeding and mortality. Confirmative studies are warranted to further evaluate the potential of this user-friendly stratification strategy in daily practice.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: AF Miscellaneous and Surgical Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1236-092
- 2017 American College of Cardiology Foundation