P2700Fatal risk of warfarin in asian very elderly patients with atrial fibrillation in direct oral anti-coagulant era

Background: The prevarence rate of atrial fibrillation (AF) is 10% in people over 80 years-old in Japan. For the aging countries such as Japan, AF management including anticagulant therapy is a major concern because of its serious complication and poor prognosis. In particular, Asian elderly patients have a higher bleeding risk. Though direct oral anti-coagulant (DOAC) became available for use in such patients, there is no reliable evidence of not only DOAC but also warfarin (WF). Purpose: To clarify the efficacy and safety of anticoagulant drug in Asian very elderly patients, we evaluated the clinical events, including systemic thromboembolism (SSE), bleeding, and death in very elderly AF patients requiring anticoagulant therapy. Method: We retrospectively investigated consecutive 540 Japanese nonvalvular AF (NVAF) patients who were over 80 years-old and have been prescribed WF or DOAC in the period from March 2011 to October 2016. We compared the incidence of SSE, major bleeding, and either SSE or bleeding related death between patients taking WF (WF group; n=248) and patients taking DOAC (DOAC group; n=292).