Vincenzo Russo1, Emilio Attena2, Carmine Mazzone3, Enrico Melillo4, Anna Rago4, Gennaro Galasso5, Lucia Riegler6, Valentina Parisi7, Raffaele Rotunno2, Gerardo Nigro4, Antonio D'Onofrio8. 1. Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy. Electronic address: v.p.russo@libero.it. 2. Cardiology Unit, Roccadaspide Hospital, Roccadaspide, SA, Italy. 3. Cardiovascular Centre, Health Authority 1, Trieste, Italy. 4. Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy. 5. Department of Cardiology, San Giovanni di Dio e Ruggi d'Aragona Hospital, Salerno, Italy. 6. Cardiology Unit, San Francesco d' Assisi Hospital, Oliveta Citra, SA, Italy. 7. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy. 8. Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Monaldi Hospital, Naples, Italy.
Abstract
PURPOSE: The purpose of the current study was to compare the efficacy and safety of edoxaban versus vitamin K antagonist (VKA) therapy among a cohort of elderly patients (ie, those aged ≥75 years) with atrial fibrillation (AF) in a real-life setting. METHODS: A propensity score-matched cohort observational study was performed comparing the safety and efficacy of edoxaban versus VKA therapy among a cohort of elderly (aged ≥75 years) patients with AF in a real-life setting. Follow-up data were obtained through outpatient visits at 1, 3, and every 6 months. The primary safety outcome was major bleeding. The primary efficacy outcome was the composite of stroke, transient ischemic attack, and systemic embolism. FINDINGS: A total of 130 patients receiving edoxaban 60 mg (EDO) treatment were compared with the same number of VKA recipients. The mean follow-up was 16 (2.6) months. The cumulative incidence of thromboembolic events in the EDO and VKA groups was 1.5% (2 of 130) and 2.3% (3 of 130), respectively (P < 0.6). The cumulative incidence of major bleeding events was 1.5% (2 of 130) in the EDO group and 3.1% (4 of 130) in the VKA group (P < 0.4). The total anticoagulant therapy discontinuation rate was 2.3% (3 of 130) in the EDO group and 4.6% (6 of 130) in the VKA group (P < 0.3). A nonsignificant trend in improved adherence was observed between the EDO and VKA groups (81% vs 78%; P = 0.6). IMPLICATIONS: Edoxaban therapy showed a good real-life performance among elderly patients (aged ≥75 years) with AF.
PURPOSE: The purpose of the current study was to compare the efficacy and safety of edoxaban versus vitamin K antagonist (VKA) therapy among a cohort of elderly patients (ie, those aged ≥75 years) with atrial fibrillation (AF) in a real-life setting. METHODS: A propensity score-matched cohort observational study was performed comparing the safety and efficacy of edoxaban versus VKA therapy among a cohort of elderly (aged ≥75 years) patients with AF in a real-life setting. Follow-up data were obtained through outpatient visits at 1, 3, and every 6 months. The primary safety outcome was major bleeding. The primary efficacy outcome was the composite of stroke, transient ischemic attack, and systemic embolism. FINDINGS: A total of 130 patients receiving edoxaban 60 mg (EDO) treatment were compared with the same number of VKA recipients. The mean follow-up was 16 (2.6) months. The cumulative incidence of thromboembolic events in the EDO and VKA groups was 1.5% (2 of 130) and 2.3% (3 of 130), respectively (P < 0.6). The cumulative incidence of major bleeding events was 1.5% (2 of 130) in the EDO group and 3.1% (4 of 130) in the VKA group (P < 0.4). The total anticoagulant therapy discontinuation rate was 2.3% (3 of 130) in the EDO group and 4.6% (6 of 130) in the VKA group (P < 0.3). A nonsignificant trend in improved adherence was observed between the EDO and VKA groups (81% vs 78%; P = 0.6). IMPLICATIONS: Edoxaban therapy showed a good real-life performance among elderly patients (aged ≥75 years) with AF.
Authors: Anna Rago; Enrica Pezzullo; Marco Malvezzi Caracciolo d'Aquino; Gabriella Scognamiglio; Valentina Maria Caso; Francesco Martone; Emilio Attena; Valentina Parisi; Antonio D'Onofrio; Paolo Golino; Gerardo Nigro; Vincenzo Russo Journal: J Blood Med Date: 2021-06-04