Key result
Lack of anticoagulation in frail elderly AF patients is linked to more stroke or bleeding.
Why the study?
Does anticoagulation therapy reduce ischemic stroke and/or bleeding in hospitalized frail elderly patients with atrial fibrillation?
Observational
Does anticoagulation therapy reduce ischemic stroke and/or bleeding in hospitalized frail elderly patients with atrial fibrillation?
Anticoagulation therapy is underutilized in hospitalized frail elderly patients with atrial fibrillation, and its omission is associated with a higher risk of ischemic stroke and/or bleeding at 1 year.
May warrant anticoagulation consideration in frail elderly AF inpatients; extends observational data but leaves net benefit unresolved pending RCTs.
BACKGROUND AND OBJECTIVE: Multiple chronic conditions and recurring acute illness are frequent among elderly people. One such condition is atrial fibrillation (AF), which increases the risk of stroke up to fivefold. The aim of this study was to investigate the prevalence of AF among hospitalized frail elderly patients, their use of anticoagulation and their 12-month outcomes. PATIENTS AND CONCLUSION: The prevalence of AF in a hospitalized frail elderly population was 47%. Of these, 63% were prescribed anticoagulation therapy. Almost half of the patients without stroke prophylaxis had no documented contraindication. At 1 year, there were significantly more events in terms of ischemic stroke and/or bleeding among AF patients without anticoagulation therapy than among those with.
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Ekerstad et al. (2018) conducted an observational in Atrial fibrillation. Anticoagulation therapy vs. No anticoagulation therapy was evaluated on Ischemic stroke and/or bleeding (p=0.001). Among hospitalized frail elderly patients with atrial fibrillation, those without anticoagulation therapy had significantly more ischemic stroke and/or bleeding events at 1 year (P=0.001).
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