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Progression over time of changes in anticoagulant treatment in a tertiary hospital

Paula Hernández1, Lucia Polanco1, Ignacio Santiago1

  • 1Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, España.

Medicina Clinica
|November 6, 2020
PubMed

Insights

Anticoagulant use in internal medicine inpatients rose significantly, particularly for those with atrial fibrillation. Direct oral anticoagulants (DOACs) became more common, reflecting updated treatment guidelines.

Area of Science:

  • Internal Medicine
  • Pharmacology
  • Geriatrics

Background:

  • Direct oral anticoagulants (DOACs) have significantly influenced anticoagulant therapy guidelines.
  • Anticoagulant use has evolved, necessitating an understanding of current trends in clinical practice.

Observation:

  • A study of 1584 inpatients in 2008 and 2018 revealed a rise in anticoagulant prevalence from 13.1% to 18.8%.
  • The mean age of anticoagulated patients increased significantly, with a doubling of those over 75 years old.
  • Atrial fibrillation prevalence also increased, with a marked rise in anticoagulated patients diagnosed with this condition.

Findings:

  • Direct oral anticoagulants (DOACs) were used by 52% of anticoagulated patients in 2018.
  • The prevalence of atrial fibrillation among anticoagulated patients rose substantially from 32.3% to 56% between 2008 and 2018.
  • Older patient demographics and increased atrial fibrillation prevalence are key drivers of changing anticoagulant prescribing patterns.

Implications:

  • These findings highlight a significant shift towards increased anticoagulation in internal medicine, especially for elderly patients with atrial fibrillation.
  • The growing adoption of DOACs suggests a transition in clinical practice aligned with updated therapeutic recommendations.
  • Future research should focus on the long-term outcomes and safety profiles of DOACs in diverse inpatient populations.
Abstract

Keywords:
AnticoagulaciónAnticoagulantes orales de acción directaAnticoagulationAtrial fibrillationDirect oral anticoagulantsFibrilación auricular

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