Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older

Patrick Manckoundia, Gilles Nuemi, Arthur Hacquin, Didier Menu, Clémentine Rosay, Jérémie Vovelle, Valentine Nuss, Camille Baudin-Senegas, Jérémy Barben and Alain Putot
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Patrick Manckoundia: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Gilles Nuemi: Department of Medical Information, University Hospital, 21079 Dijon, France
Arthur Hacquin: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Didier Menu: “Mutualité Sociale Agricole” of Burgundy, 21079 Dijon, France
Clémentine Rosay: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Jérémie Vovelle: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Valentine Nuss: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Camille Baudin-Senegas: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Jérémy Barben: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France
Alain Putot: “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France

IJERPH, 2021, vol. 18, issue 9, 1-12

Abstract: The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ?80 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for a medical prescription in September 2017. The demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs were compared in the DOAC group and VKA group. Of the 3190 included individuals, 1279 (40%) were prescribed DOACs and 1911 (60%) VKAs. Individuals taking VKAs were older than those taking DOACs (87.11 vs. 86.35 years). In the DOAC group, there were more women (51.92% vs. 48.25%) ( p = 0.043), less RCD (89.60% vs. 92.73%) ( p = 0.002), less VTE (1.80% vs. 6.59%), less severe heart failure (58.09% vs. 67.87%), less severe hypertension (18.22% vs. 23.60%), less severe kidney diseases (1.49% vs. 3.82%), and fewer drugs per prescription (6.15 vs. 6.66) ( p < 0.01 for all). The DOAC group were also less likely to be taking angiotensin receptor blockers (10.79% vs. 13.97%), furosemide (40.81% vs. 49.66%) or digoxin (10.32% vs. 13.66%) than the VKA group ( p = 0.009, p < 0.001, and p = 0.005). DOACs were less prescribed than VKAs. Individuals taking VKAs were older and had more severe comorbidities and more drugs per prescription than those taking DOACs.

Keywords: aged 80 and over; anticoagulant; direct oral anticoagulants; vitamin K antagonists (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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