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One-year outcomes of elderly patients with atrial fibrillation: snapshot data from the global noninterventional program on edoxaban treatment in routine clinical practice in atrial fibrillation

Session Poster Session 5

Speaker Associate Professor Chun-Chieh Wang

Event : ESC Congress 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Oral Anticoagulation
  • Session type : Poster Session

Authors : CC Wang (Taipei,TW), YH Kim (Seoul,KR), B Brueggenjuergen (Berlin,DE), R De Caterina (Pisa,IT), P Kirchhof (Birmingham,GB), BC Lee (Anyang-Si, Gyeonggi-Do,KR), P Levy (Paris,FR), H Rauer (Munich,DE), PE Reimitz (Munich,DE), M Unverdorben (Basking Ridge,US), T Yamashita (Tokyo,JP), Y Koretsune (Osaka,JP)

Authors:
C.C. Wang1 , Y.H. Kim2 , B. Brueggenjuergen3 , R. De Caterina4 , P. Kirchhof5 , B.C. Lee6 , P. Levy7 , H. Rauer8 , P.E. Reimitz8 , M. Unverdorben9 , T. Yamashita10 , Y. Koretsune11 , 1Chang Gung University, Department of Cardiology - Taipei - Taiwan , 2Korea University College of Medicine, Department of Internal Medicine - Seoul - Korea (Republic of) , 3Steinbeis-University, Head Institute for Health Economics - Berlin - Germany , 4University of Pisa, Chair of Cardiology - Pisa - Italy , 5University of Birmingham, Institute of Cardiovascular Sciences - Birmingham - United Kingdom , 6Hallym University Sacred Heart Hospital - Anyang-Si, Gyeonggi-Do - Korea (Republic of) , 7Universite Paris-Dauphine - Paris - France , 8Daiichi Sankyo Europe GmbH - Munich - Germany , 9Daiichi Sankyo, Inc - Basking Ridge - United States of America , 10Cardiovascular Institute - Tokyo - Japan , 11National Hospital Organization Osaka National Hospital - Osaka - Japan ,

Topic(s):
Oral Anticoagulation

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 2992

Background: As populations age, prevalence of atrial fibrillation (AF) and ensuing need for oral anticoagulation increase. Benefits and risks of nonvitamin K antagonist oral anticoagulants such as edoxaban in the frail, elderly population with AF in regular clinical care is of special interest.

Purpose: Data from Global ETNA-AF capturing almost 20000 patients treated with edoxaban in Europe, Japan, and Korea/Taiwan, was analyzed to compare outcomes in patients <75 years, elderly (≥75 years), and very elderly (≥85 years) patients.

Methods: Global ETNA-AF is a multinational, multicentre, prospective, noninterventional program (EU: NCT02944019, Japan: UMIN000017011, Korea/Taiwan: NCT02951039). Demographics, baseline characteristics, and 1-year outcome data were reported for 19416 patients classified into 3 age categories.

Results: At 1-year follow-up, rates of major bleeding (including intracranial haemorrhage [ICH]) and ischaemic stroke were generally low. All-cause and CV mortality increased with age; CV mortality was a minor proportion of all-cause mortality in all age groups. Rates of major bleeding and ischaemic stroke increased slightly with age, but to a lesser extent than all-cause and CV mortality. There was no increase in the rate of ICH with age.

Conclusion: Global data from this set of unselected patients support the use of edoxaban as a safe and effective treatment in elderly and very elderly patients with AF in regular clinical care.

<75 yrs (N=9725)≥75 yrs (N=9687)≥85 yrs (N=2186)
Age, median (IQR)68.0 (63.0, 72.0)80.0 (77.0, 84.0)87.0 (86.0, 89.0)
Gender, male %65.851.541.4
BMI, median (IQR)25.6 (22.9, 29.0)24.5 (21.9, 27.5)23.4 (20.8, 26.1)
Weight, median (IQR) kg71.0 (60.0, 84.5)62.5 (52.9, 75.0)55.4 (47.6, 67.0)
CHA2DS2-VASc, mean (SD)2.4 (1.28)4.1 (1.27)4.4 (1.34)
CrCl [mL/min], median (IQR)78.4 (63.6, 95.9)52.0 (41.1, 64.5)40.3 (32.2, 49.4)
Edoxaban 60/30 mg, %64.0/36.034.3/65.715.8/84.2
1-year outcome, n (%/year)
  Major bleeding (ISTH)57 (0.71)93 (1.19)25 (1.53)
  Intracranial hemorrhage22 (0.27)22 (0.28)3 (0.18)
  Major GI* bleeding18 (0.22)36 (0.46)16 (0.98)
  CRNMB**126 (1.57)212 (2.73)56 (3.45)
  Ischaemic stroke53 (0.66)83 (1.06)23 (1.41)
  All-cause/CV mortality95 (1.18)/25 (0.31)224 (2.86)/55 (0.70)89 (5.44)/23 (1.41)
*Gastrointestinal. **Clinically relevant nonmajor bleeding.

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