The use of antiplatelet medication in hospitalised elderly patients

Wawruch, Martin; Slezakova, Veronika; Murı́n, J; Kuželová, M; Dukát, Andrej; Zabka, Matthew; Leitmann, Tatiana; Tisonova, J; Kállay, Z

doi:10.4149/bll_2015_102

Cited by 1 publication

(2 citation statements)

References 24 publications

(36 reference statements)

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“…In our study, we did not find that patient characteristics, regardless of the medical history, led to changes in therapy. Notably, though patient age has previously been described as a risk factor for the underuse of PAI, it did not influence prescriptions in our population [27,31]. Underuse of beneficial medications is frequently reported for the oldest old, including for PAI [34].…”

Section: Factors Associated With Pai Prescriptionsmentioning

confidence: 51%

“…Another investigation in patients discharging from hospital after myocardial infarction reported a PAI prescription in 88% of patients aged <75 years but only in 66% after the age of 84 [11]. Another study found that only a half of patients with a history of stroke or coronary artery disease had received a prescription for PAI prior to hospitalization [31].…”

Section: Pai In Older Patients: From Underuse To Overusementioning

confidence: 99%

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Impact of Age, Multimorbidity and Frailty on the Prescription of Preventive Antiplatelet Therapy in Older Population

Laborde

Barben

Mihai

et al. 2020

IJERPH

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Platelet aggregation inhibitors (PAI) have widely proven their efficiency for the prevention of ischemic cardiovascular events. We aimed to describe PAI prescription in an elderly multimorbid population and to determine the factors that influence their prescription, including the impact of age, comorbidities and frailty, evaluated through a comprehensive geriatric assessment. This cross-sectional study included all patients admitted to the acute geriatric department of a university hospital from November 2016 to January 2017. We included 304 consecutive hospitalized patients aged 88.7 ± 5.5 years. One third of the population was treated with PAI. A total of 133 (43.8%) patients had a history of cardiovascular disease, 77 of whom were on PAI. For 16 patients, no indication was identified. The prescription or the absence of PAI were consistent with medical history in 61.8% of patients. In the multivariate analysis, among the 187 patients with an indication for PAI, neither age (odds ratio (OR) = 1.00; 95% confidence interval (CI): [0.91–1.08], per year of age), nor comorbidities (OR = 0.97; 95% CI: [0.75–1.26], per point of Charlson comorbidity index), nor cognitive disorders (OR = 0.98; 95% CI [0.91–1.06] per point of Mini Mental State Examination), nor malnutrition (OR = 1.07; 95% CI [0.96–1.18], per g/L of albumin) were significantly associated with the therapeutic decision. PAI were less prescribed in primary prevention situations, in patients taking anticoagulants and in patients with a history of bleeding. In conclusion, a third of our older comorbid population of inpatients was taking PAI. PAI prescription was consistent with medical history for 61.8% of patients. Age, multimorbidity and frailty do not appear to have a significant influence on therapeutic decision-making. Further research is needed to confirm such a persistence of cardiovascular preventive strategies in frail older patients from other settings and to assess whether these strategies are associated with a clinical benefit in this specific population.

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Section: Factors Associated With Pai Prescriptionsmentioning

confidence: 51%

Section: Pai In Older Patients: From Underuse To Overusementioning

confidence: 99%