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January 26, 2021Circulation JournalOpen Access

Impact of Frailty on Bleeding Events Related to Anticoagulation Therapy in Patients With Atrial Fibrillation

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Why the study?

Anticoagulation is sometimes withheld from elderly patients with AF due to concerns about frailty, but whether frailty increases bleeding events remains unknown.

Does a high frailty index increase the risk of major bleeding events in patients with non-valvular atrial fibrillation receiving anticoagulation therapy?

Population

120 consecutive non-valvular AF patients admitted with AF symptoms or congestive heart failure

Comparison

CHS frailty index score or risk categories

Design

Retrospective analysis

Follow-up

Median 518 days

Authors

MOMasayuki OhtaCardiovascular Center Hokkaido Ohno HospitalKHKentarō HayashiUniversity of Tokyo HospitalYMYuichiro MoriInterventional Cardiology

Discussion

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Member takes

Overview

Frailty may warrant bleeding risk caution during anticoagulation in AF; leaves open whether frailty assessment should guide therapy.

Structured PICO

Does a high frailty index increase the risk of major bleeding events in patients with non-valvular atrial fibrillation receiving anticoagulation therapy?

P
Population
120 consecutive patients with non-valvular atrial fibrillation admitted with symptoms of AF or congestive heart failure
I
Intervention
High frailty (Cardiovascular Health Study frailty index ≥2) while on anticoagulation therapy
C
Comparator
Low frailty (Cardiovascular Health Study frailty index <2) while on anticoagulation therapy
O
Outcome
Major bleeding eventssafety

Frailty, defined by a CHS frailty index ≥2, is significantly associated with an increased risk of major bleeding events in patients with non-valvular atrial fibrillation receiving anticoagulation.

Cite This Study

Ohta et al. (2021) studied this question.

synapsesocial.com/papers/6a717f5bf44fa9f079df4988https://doi.org/10.1253/circj.cj-20-0373
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation2024 · 10 citations
  2. 2Frailty to predict unplanned hospitalization, stroke, bleeding, and death in atrial fibrillation2020 · 58 citations
  3. 3Anticoagulants in frail elderly patients with atrial fibrillation: a delicate balance2023
  4. 4Anticoagulant Therapy for Frail Patients with Atrial Fibrillation2021 · 8 citations
  5. 5Frailty and subsequent adverse outcomes in older patients with atrial fibrillation treated with oral anticoagulants: The Shizuoka study2023 · 13 citations