Perceived vs. objective frailty in patients with atrial fibrillation and impact on anticoagulant dosing: an ETNA-AF-Europe sub-analysis
Key result
Perceived frailty (10.6%) and objective frailty (5.0%) in AF patients showed minimal overlap (<1%), but both were associated with non-recommended anticoagulant dosages.
Why the study?
Definitions of frailty in AF vary and may not overlap with physicians' perceptions, which can impact therapies and outcomes.
How does perceived versus objective frailty impact anticoagulant dosing in patients with atrial fibrillation?
Population
13 621 patients with non-valvular AF in ETNA-AF-Europe with baseline frailty data
Comparison
Subjective investigator judgement of frailty vs objective Modified Frailty Index
Design
Prospective, multi-centre, post-authorization, observational study sub-analysis
Authors
Discussion
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Implication
Both perceived and objective frailty associate with non-recommended dosing despite minimal overlap; leaves open whether standardized tools improve AF anticoagulation accuracy.
Study Design
Type
Observational (n=13,621)
Multicenter
Yes
Structured PICO
How does perceived versus objective frailty impact anticoagulant dosing in patients with atrial fibrillation?
P
Population
13,621 patients with non-valvular atrial fibrillation in the ETNA-AF-Europe registry assessed for perceived versus objective frailty.
E
Exposure
Subjective physician assessment of frailty
C
Comparator
Objective assessment of frailty using the Modified Frailty Index
O
Outcome
Prevalence of perceived versus objective frailty and frequency of non-recommended edoxaban dose regimens
Main Result
Absolute Event Rate: 10.6% vs 5%
Physicians' subjective perception of frailty in AF patients differs significantly from objective assessment, but both are associated with inappropriate anticoagulant dosing.
Limitations
- Whether the apparent inappropriateness of anticoagulant dosages influences hard outcomes remains to be assessed
Cite This Study
Diemberger et al. (2022) conducted an observational in atrial fibrillation (n=13,621). Perceived frailty vs. Objective frailty was evaluated on Prevalence of frailty. Perceived frailty (10.6%) and objective frailty (5.0%) in AF patients showed minimal overlap (<1%), but both were associated with non-recommended anticoagulant dosages.