Key result
Antiplatelet medication was prescribed in 29.14% of ambulatory elderly patients, who had significantly higher rates of coronary heart disease (35.15% vs 14.49%, P<0.0001) than those without.
Why the study?
What are the clinical characteristics and comorbidities of very elderly ambulatory patients prescribed antiplatelet medication compared to those who are not?
Observational (n=15,141)
What are the clinical characteristics and comorbidities of very elderly ambulatory patients prescribed antiplatelet medication compared to those who are not?
Nearly one-third of very elderly ambulatory patients are prescribed antiplatelet medication, which is significantly associated with a higher prevalence of cardiovascular comorbidities and concurrent cardiovascular medication use.
Antiplatelet prescriptions linked to higher CHD rates in ambulatory patients over 80; cross-sectional data leaves open appropriateness and outcomes.
OBJECTIVE: Despite the frequent use of antiplatelet medication (AM) in the elderly patients, very few studies have investigated its prescription. We describe AM prescription through retrospective study in ambulatory elderly patients. METHOD: All subjects aged over 80 years with a medical prescription delivered in March 2015 and affiliated to the Mutualité Sociale Agricole de Bourgogne. Subjects with prescriptions for AM were compared with those without. RESULTS: A total of 15 141 ambulatory elderly patients (83-89 years, 61.3% of women) were included and 4412 (29.14%) had a prescription for AM. The latter were more frequently men than those without AM (43% vs 36.93%, P < .0001) and more frequently had chronic comorbidities (77.24% vs 64.65%, P < .0001). Compared with ambulatory subjects without AM, those with AM more frequently had coronary heart disease (35.15% vs 14.49%), severe hypertension (30% vs 25.65%), diabetes (27.42% vs 20.64%), peripheral arterial diseases (16.28% vs 5.96%) and disabling stroke (9% vs 5.56% (all P < .0001). In addition, they had more prescriptions of beta-blockers (45.24% vs 36.90%), angiotensin conversion enzyme inhibitor (31.35% vs 25.44%), calcium channel blockers (33.34% vs 27.90%), nitrate derivatives (10.6% vs 6.03%) or hypolipidemic agents (HA; 49.81% vs 29.72%) (all P < .0001) than those without AM. CONCLUSION: In this study, which is very interested for its size and the advanced age of the subjects, long-course AM was prescribed in one third of ambulatory elderly patients. Coronary heart disease, severe hypertension and diabetes were more frequent in AM subjects. However, the low percentage of declared strokes was surprising. We provide additional data to doctors following subjects with AM.
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Manckoundia et al. (2017) conducted an observational in Ambulatory elderly patients (n=15,141). Antiplatelet medication vs. No antiplatelet medication was evaluated on Prevalence of antiplatelet medication prescription. Antiplatelet medication was prescribed in 29.14% of ambulatory elderly patients, who had significantly higher rates of coronary heart disease (35.15% vs 14.49%, P<0.0001) than those without.
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