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. Titre, Réunion de concertation pluridisciplinaire à propos de l'anticoagulation du sujet âgé en fibrillation atriale : état des lieux après deux ans de fonctionnement

. Résumé, L'anticoagulation du sujet âgé ayant une fibrillation atriale (FA) n'est pas toujours d'indication évidente. C'est suite à ce constat qu'a été créée une Réunion de

, Concertation Pluridisciplinaire (RCP) « Anticoagulants », où des gériatres, neurologues et cardiologues discutent des cas difficiles

, Les objectifs secondaires étaient de différencier plusieurs profils type de patient, de rechercher des facteurs prédictifs de la décision d'anticoagulation, de connaître le ressenti des médecins généralistes concernant la RCP. Il s'agissait d'une étude descriptive puis cas-témoin, avec analyses uni et multivariées. Les patients inclus avaient plus de 75 ans, un trouble du rythme cardiaque et avaient été présentés en RCP entre janvier 2016 et janvier 2018. 86 patients ont été inclus, l'âge moyen était de 87 ans, 46% des patients avaient un antécédent d'accident vasculaire cérébral (AVC), 42% un antécédent de maladie vasculaire. Les motifs de présentation en RCP ont été séparés en 4 catégories : risque hémorragique, risque embolique, analyse descriptive des caractéristiques des patients, des motifs de présentation en RCP et des réponses apportées par la RCP, vol.738, pp.329-339

, p=0,013) et le fait d'être anticoagulé avant la RCP (OR ajusté (IC à 95 %): 3,820, vol.098, pp.35-49

, Les médecins généralistes ont été enthousiastes à propos de cette initiative, cependant la communication de la RCP a été jugée insuffisante, et la RCP gagnerait à une meilleure transmission de ses résultats

, Mots clés (français) : sujet âgé, fibrillation atriale, anticoagulant, réunion de concertation pluridisciplinaire

, Université Paris Descartes Faculté de Médecine Paris Descartes 15