ISSN 1671-5411 CN 11-5329/R
Rungroj Krittayaphong, Arintaya Phrommintikul, Pornchai Ngamjanyaporn, Khanchai Siriwattana, Wiwat Kanjanarutjawiwat, Thoranis Chantrarat, Roj Rojjarekampai, Pontawee Kaewcomdee, Patthrapon Sonkhammee. Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry. J Geriatr Cardiol 2019; 16(3): 242-250. doi: 10.11909/j.issn.1671-5411.2019.03.004
Citation: Rungroj Krittayaphong, Arintaya Phrommintikul, Pornchai Ngamjanyaporn, Khanchai Siriwattana, Wiwat Kanjanarutjawiwat, Thoranis Chantrarat, Roj Rojjarekampai, Pontawee Kaewcomdee, Patthrapon Sonkhammee. Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry. J Geriatr Cardiol 2019; 16(3): 242-250. doi: 10.11909/j.issn.1671-5411.2019.03.004

Rate of anticoagulant use, and factors associated with not prescribing anticoagulant in older Thai adults with non-valvular atrial fibrillation: A multicenter registry

doi: 10.11909/j.issn.1671-5411.2019.03.004
Funds:

This study was funded by the Health Systems Research Institute (HSRI), Nonthaburi, Thailand (grant no. 59-053), the Heart Association of Thailand under the Royal Patron-age of H.M. the King, Bangkok, Thailand, and The Royal College of Physicians of Thailand, Bangkok, Thailand.

  • Received Date: 2018-12-12
  • Rev Recd Date: 2019-01-15
  • Publish Date: 2019-03-28
  • 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 (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.
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