RESUMO
BACKGROUND AND AIMS: Atrial fibrillation (AF) is the most common arrhythmia in elderly people, yet oral anticoagulation is underused in the aged. We tried to determine whether new oral anticoagulants (NOA) have greater psychological tolerability than warfarin. METHODS: Age-, gender-matched groups of AF patients receiving NOA (N = 15) or warfarin (N = 15) were assessed with the Anti-Clot Treatment Scale (ACTS) and the Perceived Stress Scale (PSS). RESULTS: Patients were old (81 ± 9 years). NOA group showed greater psychological satisfaction, with lower therapy-related burden (ACTS burdens: 16.3 ± 4.5 vs. 32.9 ± 10.2, p < 0.001) and higher awareness of benefits (ACTS benefits: 13.0 ± 1.3 vs. 10.8 ± 1.9, p = 0.001). Even stress was lower (PSS: 13.1 ± 4.0 vs. 17.1 ± 4.2, p = 0.013). The multivariate analysis confirmed these findings, showing that higher levels of anxiety and depression could justify more stress in warfarin patients. CONCLUSIONS: The results of this preliminary study show that NOA have an improved psychological impact compared with warfarin in elderly patients.
Assuntos
Anticoagulantes/uso terapêutico , Fibrilação Atrial/tratamento farmacológico , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/psicologia , Feminino , Humanos , Masculino , Satisfação do Paciente , Estresse Psicológico/etiologia , Varfarina/uso terapêuticoAssuntos
Insuficiência Adrenal/tratamento farmacológico , Hidrocortisona/administração & dosagem , Bombas de Infusão , Insuficiência Adrenal/complicações , Adulto , Ritmo Circadiano , Esquema de Medicação , Feminino , Seguimentos , Humanos , Hidrocortisona/sangue , Hipersensibilidade/complicações , Hipersensibilidade/tratamento farmacológico , Infusões SubcutâneasRESUMO
Rheumatoid arthritis is a chronic autoimmune inflammatory disease associated with increased cardiovascular risk and higher mortality in respect to general population. Beyond joint disease, inflammation is the major determinant of accelerated atherosclerosis observed in rheumatoid arthritis. We review the relationship between inflammation, atherosclerosis and cardiovascular risk in rheumatoid arthritis, focusing on the assessment of subclinical atherosclerosis by functional and morphological methods. These tools include flow mediated dilatation, carotid intima-media thickness, ankle/brachial index, coronary calcium content, pulse wave analysis and serum biomarker of subclinical atherosclerosis.