1
|
Wang Y, Guo Y, Qin M, Fan J, Tang M, Zhang X, Wang H, Li X, Lip GYH, Expert Reviewers *. 2024 Chinese Expert Consensus Guidelines on the Diagnosis and Treatment of Atrial Fibrillation in the Elderly, Endorsed by Geriatric Society of Chinese Medical Association (Cardiovascular Group) and Chinese Society of Geriatric Health Medicine (Cardiovascular Branch): Executive Summary. Thromb Haemost 2024; 124:897-911. [PMID: 38744425 PMCID: PMC11436293 DOI: 10.1055/a-2325-5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/04/2024] [Indexed: 05/16/2024]
Abstract
The consensus guidelines of the Geriatric Society of Chinese Medical Association on the management of atrial fibrillation (AF) in the elderly was first published in 2011 and updated in 2016, with endorsement by Chinese Society of Geriatric Health Medicine. Since then, many important studies regarding the screening and treatment in the elderly population have been reported, necessitating this updated expert consensus guideline. The writing committee members comprehensively reviewed updated evidence pertaining to elderly patients with AF, and formulated this 2024 update. The highlighted issues focused on the following: screening for AF, geriatric comprehensive assessment, use of the Atrial fibrillation Better Care (ABC) pathway for the elderly patients, and special clinical settings related to elderly patients with AF. New recommendations addressing smart technology facilitated AF screening, ABC pathway based management, and optimal anticoagulation were developed, with a focus on the elderly.
Collapse
Affiliation(s)
- Yutang Wang
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Yutao Guo
- Pulmonary Vessel and Thrombotic Disease, Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingzhao Qin
- Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jin Fan
- Department of Cardiology, Beijing Taikang Yanyuan Rehabilitation Hospital, Beijing, China
| | - Ming Tang
- Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xinjun Zhang
- Geriatric Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiaoying Li
- Department of Cardiology, Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Gregory Y. H. Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Danish Center for Health Services Research, Aalborg University, Aalborg, Denmark
| | | |
Collapse
|
2
|
Unverdorben M, Colonna P, Jin J, Köhler S, Santamaria A, Saxena M, Borrow A, Chen C, von Heymann C, Vanassche T. Periprocedural Edoxaban Management and Clinical Outcomes in Patients Undergoing Transcatheter Cardiovascular Procedures in the EMIT-AF/VTE Program. Clin Appl Thromb Hemost 2024; 30:10760296241260728. [PMID: 38881370 PMCID: PMC11185023 DOI: 10.1177/10760296241260728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/17/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
Clinical trial registration number: NCT02950168, NCT02951039.
Collapse
Affiliation(s)
- Martin Unverdorben
- Global Specialty Medical Affairs, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Paolo Colonna
- Department of Cardiology, Polyclinic of Bari – Hospital, Bari, Italy
| | - James Jin
- Global Specialty Medical Affairs, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | | | - Amparo Santamaria
- Hematology Department, University Hospital Vinalopó y Torrevieja, Alicante, Spain
| | - Manish Saxena
- William Harvey Research Institute, NIHR Barts Cardiovascular Biomedical Research Centre, London, UK
| | - Amanda Borrow
- Global Specialty Medical Affairs, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Cathy Chen
- Global Specialty Medical Affairs, Daiichi Sankyo, Inc., Basking Ridge, NJ, USA
| | - Christian von Heymann
- Department of Anaesthesia & Intensive Care Medicine, Emergency Medicine, and Pain Therapy, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Thomas Vanassche
- Department of Cardiovascular Sciences, University Hospitals (UZ) Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Köhler C, Tittl L, Hänsel U, Hammermüller E, Marten S, Naue C, Spindler M, Stannek L, Fache K, Beyer-Westendorf J. Periinterventional Management of Edoxaban in Major Procedures: Results from the DRESDEN NOAC REGISTRY. TH OPEN 2023; 7:e251-e261. [PMID: 37746027 PMCID: PMC10516686 DOI: 10.1055/s-0043-1774304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/26/2023] [Indexed: 09/26/2023] Open
Abstract
Background Edoxaban is a non-vitamin K dependent oral anticoagulant (NOAC) licensed for venous thromboembolism (VTE) treatment or stroke prevention in atrial fibrillation. Major surgical procedures are not uncommon in anticoagulated patients but data on perioperative edoxaban management are scarce. Patients and Methods Using data from the prospective DRESDEN NOAC REGISTRY, we extracted data on major surgical procedures in edoxaban patients. Periinterventional edoxaban management patterns and rates of outcome events were evaluated until day 30 after procedure. Results Between 2011 and 2021, 3,448 procedures were identified in edoxaban patients, including 287 (8.3%) major procedures. A scheduled interruption of edoxaban was observed in 284/287 major procedures (99%) with a total median edoxaban interruption time of 11.0 days (25-75th percentile: 5.0-18.0 days). Heparin bridging was documented in 183 procedures (46 prophylactic dosages, 111 intermediate and 26 therapeutic dosages). Overall, 7 (2.4%; 95% CI: 1.2-4.9%) major cardiovascular events (5 VTE, 2 arterial thromboembolic events) and 38 major bleedings (13.2%; 95% CI: 9.8-17.7%) were observed and 6 patients died (2.1%; 95% CI: 1.0-4.5%). Rates of major cardiovascular events with or without heparin bridging were comparable (4/137; 2.9%; 95% CI: 1.1-7.3% vs. 3/82; 3.7%; 95% CI: 1.3-10.2%). Major bleedings occurred numerically more frequent in patients receiving heparin bridging (23/137; 16.8%; 95% CI: 11.5-23.9%) versus procedures without heparin bridging (9/82; 11.0%; 95% CI: 5.9-19.6%). Conclusion Within the limitations of our study design, real-world periprocedural edoxaban management seems effective and safe. Use of heparin bridging seems to have limited effects on reducing vascular events but may increase bleeding risk.
Collapse
Affiliation(s)
- Christina Köhler
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Luise Tittl
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Ulrike Hänsel
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Evelyn Hammermüller
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Sandra Marten
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Christiane Naue
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Marianne Spindler
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Laura Stannek
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Kristina Fache
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| | - Jan Beyer-Westendorf
- Division of “Thrombosis and Hemostasis,” Department of Medicine I, University Hospital “Carl Gustav Carus,” Technical University Dresden, Dresden, Germany
| |
Collapse
|
4
|
Unverdorben M, von Heymann C, Santamaria A, Saxena M, Vanassche T, Jin J, Laeis P, Wilkins R, Chen C, Colonna P. Correction to: Elderly patients with atrial fibrillation in routine clinical practice: peri-procedural management of edoxaban oral anticoagulation therapy is associated with a low risk of bleeding and thromboembolic complications: a subset analysis of the prospective, observational, multinational EMIT-AF study. BMC Cardiovasc Disord 2021; 21:91. [PMID: 33588744 PMCID: PMC7885390 DOI: 10.1186/s12872-021-01873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
Collapse
Affiliation(s)
- M Unverdorben
- Global Medical Affairs Specialty and Value Products, Daiichi Sankyo Inc., 211 Mt Airy Road, Basking Ridge, NJ, 07920, USA.
| | - C von Heymann
- Department of Anaesthesia and Intensive Care Medicine, Emergency Medicine, and Pain Therapy, Vivantes Klinikum Im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Germany
| | - A Santamaria
- Hematology Department, University Hospital Vilaopó y Torrevieja, Alicante, Spain
| | - M Saxena
- William Harvey Research Institute, Barts Health NHS Trust, Charterhouse Square, London, EC1M 6BQ, UK
| | - T Vanassche
- Department of Cardiovascular Sciences, University Hospitals (UZ) Leuven, Leuven, Belgium
| | - J Jin
- Global Medical Affairs Specialty and Value Products, Daiichi Sankyo Inc., 211 Mt Airy Road, Basking Ridge, NJ, 07920, USA
| | - P Laeis
- Daiichi Sankyo, Medical Affairs Europe, Munich, Germany
| | - R Wilkins
- QPS Consulting, LLC, 19884 Naples Lakes Terrace, Ashburn, VA, 20147, USA
| | - C Chen
- Global Medical Affairs Specialty and Value Products, Daiichi Sankyo Inc., 211 Mt Airy Road, Basking Ridge, NJ, 07920, USA
| | - P Colonna
- Department of Cardiology, Polyclinic of Bari - Hospital, 70124, Bari, Italy
| |
Collapse
|