Pattern of anticoagulation prescription for elderly atrial fibrillation patients with or without severe dementia: A retrospective analysis of patient data

Atrial fibrillation (AF) is a very common type of cardiac arrhythmia. Use of an anticoagulant is highly recommended. We aimed to identify the pattern of prescribing of an oral anticoagulant (OA) in patients with AF and severe dementia or patients with AF aged > 80 years. A retrospective review of medical charts was conducted in 2 tertiary care centers in Riyadh, Saudi Arabia: King Saud University Medical City and King Abdulaziz Medical City. Data for people with AF retrieved between January 2016 and December 2020 from hospital information systems. Collected data included demographics, medical history, medication history (including use of an OA or antiplatelet agent), stroke and major bleeding history. Adjusted binary logistic regression was used to predict the odds ratio (OR) of the primary outcome and secondary outcomes. The data of 620 patients were assessed. Most (60%) were women. The average age of study cohort was 79 ± 6.1 years. Most patients (88.2%) were prescribed an OA. The most commonly prescribed OA was a direct inhibitor of factor Xa (DIFXa; 48%), followed by a coumarin derivative (36%), and direct inhibitor of thrombin (16%). Patients using a coumarin derivative carried higher OR of developing severe dementia (adjusted OR = 2.687, 95%CI = 1.795-4.021, P-value < .001). Most patients suffering from AF were prescribed an OA. A DIFXa inhibitor was the most prescribed OA. Use of a coumarin derivative carried a high prevalence of dementia among our study cohort.