Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry

Background: Documenting the patterns of oral anticoagulation therapy (OAT) is essential to prevent thromboembolic complications of nonvalvular atrial fibrillation (NVAF). Objective: To report the patterns of OAT according to age and thromboembolic risk in patients included in CARMEN-AF, a nationwide...

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Main Authors: Manlio F. Márquez, Manuel A. Baños-González, Milton E. Guevara-Valdivia, Jorge Vázquez-Acosta, Manuel O. de los Ríos Ibarra, Julio A. Aguilar-Linares, Marcelo Jiménez-Cruz, Norberto Matadamas-Hernández, Rocío Camacho-Casillas, Reynaldo Magaña-Magaña, Ulises Rojel-Martínez, Marco A. Alcocer-Gamba, Susano Lara-Vaca, Humberto Rodríguez-Reyes, Marco A. Islava-Gálvez, Lidia E. Betancourt-Hernández, Nicolás Reyes-Reyes, Miguel E. Beltrán-Gámez, Carlos Cantú-Brito, Alberto Z. Baños-Velasco, Pedro J. del Rivero Morfin, J. Antonio González-Hermosillo
Format: Article
Language:English
Published: Ubiquity Press 2020-04-01
Series:Global Heart
Subjects:
Online Access:https://globalheartjournal.com/articles/767
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author Manlio F. Márquez
Manuel A. Baños-González
Milton E. Guevara-Valdivia
Jorge Vázquez-Acosta
Manuel O. de los Ríos Ibarra
Julio A. Aguilar-Linares
Marcelo Jiménez-Cruz
Norberto Matadamas-Hernández
Rocío Camacho-Casillas
Reynaldo Magaña-Magaña
Ulises Rojel-Martínez
Marco A. Alcocer-Gamba
Susano Lara-Vaca
Humberto Rodríguez-Reyes
Marco A. Islava-Gálvez
Lidia E. Betancourt-Hernández
Nicolás Reyes-Reyes
Miguel E. Beltrán-Gámez
Carlos Cantú-Brito
Alberto Z. Baños-Velasco
Pedro J. del Rivero Morfin
J. Antonio González-Hermosillo
author_facet Manlio F. Márquez
Manuel A. Baños-González
Milton E. Guevara-Valdivia
Jorge Vázquez-Acosta
Manuel O. de los Ríos Ibarra
Julio A. Aguilar-Linares
Marcelo Jiménez-Cruz
Norberto Matadamas-Hernández
Rocío Camacho-Casillas
Reynaldo Magaña-Magaña
Ulises Rojel-Martínez
Marco A. Alcocer-Gamba
Susano Lara-Vaca
Humberto Rodríguez-Reyes
Marco A. Islava-Gálvez
Lidia E. Betancourt-Hernández
Nicolás Reyes-Reyes
Miguel E. Beltrán-Gámez
Carlos Cantú-Brito
Alberto Z. Baños-Velasco
Pedro J. del Rivero Morfin
J. Antonio González-Hermosillo
author_sort Manlio F. Márquez
collection DOAJ
description Background: Documenting the patterns of oral anticoagulation therapy (OAT) is essential to prevent thromboembolic complications of nonvalvular atrial fibrillation (NVAF). Objective: To report the patterns of OAT according to age and thromboembolic risk in patients included in CARMEN-AF, a nationwide registry of NVAF in Mexico, an upper middle-income country. Material and methods: There were 1,423 consecutive patients =18 years old and with at least one thromboembolic risk factor enrolled in the CARMEN-AF Registry at their regular clinical visit during a three-year period. They were analyzed according to 1) age, 2) AF type, and 3) CHA2DS2-VASc score. Results: Overall, 16.4% of patients did not receive antithrombotic treatment, 19.4% received antiplatelet drugs (APD), 29.2% vitamin K antagonists (VKA), and 34.6% direct oral anticoagulants (DOAC). With increasing age, the proportion of subjects treated with VKA decreased significantly from 36.2% in subjects 2DS2-VASc =2) compared with the moderate risk group (41% in CHA2DS2-VASc = 1). Conclusions: VKA use for NVAF in Mexico decreased in relation to increasing age. The proportion of DOAC therapy was the same in all age groups. Nevertheless, elderly patients with high thromboembolic risk received a suboptimal thromboprophylaxis. These data could help to improve gaps in the implementation of global guidelines. Clinical trial registration: http://www.clinicaltrials.gov. Unique identifier: NCT02334852. Highlights: CARMEN-AF is a nationwide multi-centric registry seeking to bridge the data gap on anticoagulation therapy for NVAF in Mexico. Elderly patients are more prone to receive suboptimal OAT for NVAF. DOAC were less frequently used in high thromboembolic risk patients (CHA2DS2-VASc =2).
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spelling doaj.art-84bda2ed76fd4339abb1ca0b2beaa6032022-12-21T18:39:40ZengUbiquity PressGlobal Heart2211-81792020-04-0115110.5334/gh.767762Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF RegistryManlio F. Márquez0Manuel A. Baños-González1Milton E. Guevara-Valdivia2Jorge Vázquez-Acosta3Manuel O. de los Ríos Ibarra4Julio A. Aguilar-Linares5Marcelo Jiménez-Cruz6Norberto Matadamas-Hernández7Rocío Camacho-Casillas8Reynaldo Magaña-Magaña9Ulises Rojel-Martínez10Marco A. Alcocer-Gamba11Susano Lara-Vaca12Humberto Rodríguez-Reyes13Marco A. Islava-Gálvez14Lidia E. Betancourt-Hernández15Nicolás Reyes-Reyes16Miguel E. Beltrán-Gámez17Carlos Cantú-Brito18Alberto Z. Baños-Velasco19Pedro J. del Rivero Morfin20J. Antonio González-Hermosillo21Instituto Nacional de Cardiología Ignacio ChávezCentro de Investigación y Posgrado, División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco (UJAT)Unidad Médica de Alta Especialidad del Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro SocialHospital Regional de PEMEX Ciudad MaderoSINACOR, Centro para el Desarrollo de la Medicina y de Asistencia Médica Especializada S.C.Hospital Regional No.1 Tijuana, Instituto Mexicano del Seguro SocialHospital de Cardiología, Centro Médico Nacional “Siglo XXI”, Instituto Mexicano del Seguro SocialHospital General de AcapulcoUnidad Médica de Alta Especialidad No. 71, Instituto Mexicano del Seguro SocialHospital General de Uruapan “Dr. Pedro Daniel Martínez”Hospital General del Sur de Puebla “Eduardo Vázquez Navarro”Instituto de Corazón de QuerétaroHospital Ángeles LeónSociedad Cardiovascular y ArritmiasInstituto Mexicano de TrasplantesUnidad Médica de Alta Especialidad No. 14, Instituto Mexicano del Seguro SocialHospital Ángeles PueblaHospital Ángeles TijuanaDepartamento de Neurología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”Hospital Ángeles CuliacánInstituto Nacional de Cardiología Ignacio ChávezInstituto Nacional de Cardiología Ignacio ChávezBackground: Documenting the patterns of oral anticoagulation therapy (OAT) is essential to prevent thromboembolic complications of nonvalvular atrial fibrillation (NVAF). Objective: To report the patterns of OAT according to age and thromboembolic risk in patients included in CARMEN-AF, a nationwide registry of NVAF in Mexico, an upper middle-income country. Material and methods: There were 1,423 consecutive patients =18 years old and with at least one thromboembolic risk factor enrolled in the CARMEN-AF Registry at their regular clinical visit during a three-year period. They were analyzed according to 1) age, 2) AF type, and 3) CHA2DS2-VASc score. Results: Overall, 16.4% of patients did not receive antithrombotic treatment, 19.4% received antiplatelet drugs (APD), 29.2% vitamin K antagonists (VKA), and 34.6% direct oral anticoagulants (DOAC). With increasing age, the proportion of subjects treated with VKA decreased significantly from 36.2% in subjects 2DS2-VASc =2) compared with the moderate risk group (41% in CHA2DS2-VASc = 1). Conclusions: VKA use for NVAF in Mexico decreased in relation to increasing age. The proportion of DOAC therapy was the same in all age groups. Nevertheless, elderly patients with high thromboembolic risk received a suboptimal thromboprophylaxis. These data could help to improve gaps in the implementation of global guidelines. Clinical trial registration: http://www.clinicaltrials.gov. Unique identifier: NCT02334852. Highlights: CARMEN-AF is a nationwide multi-centric registry seeking to bridge the data gap on anticoagulation therapy for NVAF in Mexico. Elderly patients are more prone to receive suboptimal OAT for NVAF. DOAC were less frequently used in high thromboembolic risk patients (CHA2DS2-VASc =2).https://globalheartjournal.com/articles/767atrial fibrillationembolic riskanticoagulation therapyantithrombotic treatmentvitamin k antagonistdirect oral anticoagulantmexico
spellingShingle Manlio F. Márquez
Manuel A. Baños-González
Milton E. Guevara-Valdivia
Jorge Vázquez-Acosta
Manuel O. de los Ríos Ibarra
Julio A. Aguilar-Linares
Marcelo Jiménez-Cruz
Norberto Matadamas-Hernández
Rocío Camacho-Casillas
Reynaldo Magaña-Magaña
Ulises Rojel-Martínez
Marco A. Alcocer-Gamba
Susano Lara-Vaca
Humberto Rodríguez-Reyes
Marco A. Islava-Gálvez
Lidia E. Betancourt-Hernández
Nicolás Reyes-Reyes
Miguel E. Beltrán-Gámez
Carlos Cantú-Brito
Alberto Z. Baños-Velasco
Pedro J. del Rivero Morfin
J. Antonio González-Hermosillo
Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
Global Heart
atrial fibrillation
embolic risk
anticoagulation therapy
antithrombotic treatment
vitamin k antagonist
direct oral anticoagulant
mexico
title Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
title_full Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
title_fullStr Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
title_full_unstemmed Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
title_short Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry
title_sort anticoagulation therapy by age and embolic risk for nonvalvular atrial fibrillation in mexico an upper middle income country the carmen af registry
topic atrial fibrillation
embolic risk
anticoagulation therapy
antithrombotic treatment
vitamin k antagonist
direct oral anticoagulant
mexico
url https://globalheartjournal.com/articles/767
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