Key result
Polypharmacy in AF patients ≥75 years was associated with an increased risk of major bleeding (HR 1.16; 95% CI 1.12-1.20) and heart failure (HR 1.33; 95% CI 1.29-1.36), but not ischemic stroke.
Why the study?
Polypharmacy is common in elderly people with chronic conditions, but its impact on adverse outcomes and treatment effectiveness in elderly patients with AF remains unaddressed.
Does polypharmacy increase the risk of adverse cardiovascular outcomes and modify treatment effectiveness in patients ≥75 years with atrial fibrillation?
Population
338 810 AF patients ≥75 years of age
Comparison
Polypharmacy (≥5 active prescriptions) vs no polypharmacy
Design
Retrospective database cohort study
Authors
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May warrant monitoring for bleeding and HF in elderly AF with polypharmacy; leaves open causal effects and rhythm-control modification.
Cohort (n=338,810)
Does polypharmacy increase the risk of adverse cardiovascular outcomes and modify treatment effectiveness in patients ≥75 years with atrial fibrillation?
Hazard Ratio: 1.16 (95% CI 1.12–1.2)
In elderly patients with atrial fibrillation, polypharmacy is highly prevalent (52%) and is associated with increased risks of major bleeding and heart failure, while also modifying the effectiveness of rhythm control strategies.
Chen et al. (2020) conducted a cohort in Atrial Fibrillation (n=338,810). Polypharmacy (≥5 active prescriptions) vs. No polypharmacy was evaluated on Major bleeding (HR 1.16, 95% CI 1.12-1.20). Polypharmacy in AF patients ≥75 years was associated with an increased risk of major bleeding (HR 1.16; 95% CI 1.12-1.20) and heart failure (HR 1.33; 95% CI 1.29-1.36), but not ischemic stroke.
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