Key result
Advancing age in Japanese NVAF patients links to increased stroke risk, bleeding, and anticoagulant use.
Why the study?
Elderly patients with AF (75 years or older) have a worse prognosis than younger patients and difficult management due to multiple comorbidities, prompting an examination of age-related differences in characteristics and treatment.
Observational (n=32,726)
Yes
p-value: p=<0.0001
In a real-world registry of elderly Japanese patients with AF, advancing age was associated with higher clinical risk scores and a shift towards lower-dose warfarin and apixaban.
Age-associated rises in risks and anticoagulant use in elderly Japanese AF extend registry observations; leaves optimal age-specific strategies unresolved.
BACKGROUND: Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients. METHODS AND RESULTS: -VASc scores, and bleeding, based on HAS-BLED score, increased with age. Both warfarin and apixaban were used more often as age increased (trend P<0.0001, for each), while other anticoagulants were used less. Anticoagulant doses were significantly lower in older patients. CONCLUSIONS: Permanent/persistent AF, comorbidities, and cardiovascular and bleeding risk all increased significantly with age. Furthermore, use of warfarin and apixaban increased with age, accompanied by a decrease in other oral anticoagulant usage.
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Hiasa et al. (2020) conducted an observational in Non-valvular atrial fibrillation (n=32,726). Anticoagulant therapy vs. Age groups (75-<80, 80-<85, 85-<90, ≥90 years) was evaluated on Age-related trends in anticoagulant use (p=<0.0001). In elderly Japanese patients with non-valvular atrial fibrillation, the prevalence of comorbidities, stroke and bleeding risks, and the use of warfarin and apixaban increased significantly with advancing age.
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