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February 1, 2024Clinical Interventions in AgingOpen Access

Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation

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Key result

In elderly patients with NVAF, anticoagulation was associated with fewer thrombotic events (6.99% vs 10.98%) but more bleeding events (20.98% vs 12.72%) compared to no anticoagulation.

Why the study?

It was uncertain whether anticoagulation is safe for frail and non-frail elderly patients with nonvalvular atrial fibrillation.

Does anticoagulant therapy reduce thrombotic events and is it safe in frail and non-frail elderly patients with nonvalvular atrial fibrillation?

Population

361 elderly patients (aged ≥ 75 y) with NVAF

Comparison

Anticoagulation vs no anticoagulation, stratified by frailty status

Design

Cohort study

Follow-up

12 months

Authors

JDJiancao DingYSYing SunKZKan Zhang

Discussion

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Overview

Anticoagulation safety in frail elderly with NVAF requires individualized assessment; leaves open confirmation in randomized trials before practice change.

Study Design

Type

Cohort (n=361)

Structured PICO

Does anticoagulant therapy reduce thrombotic events and is it safe in frail and non-frail elderly patients with nonvalvular atrial fibrillation?

P
Population
361 elderly patients (aged ≥ 75 years) with nonvalvular atrial fibrillation followed for 12 months after hospital discharge.
E
Exposure
Anticoagulant therapy
C
Comparator
No anticoagulation
O
Outcome
Occurrence of thrombosis, bleeding, all-cause death, and cardiovascular eventshard clinical

Main Result

Absolute Event Rate: 6.99% vs 10.98%

In elderly patients (≥75 years) with nonvalvular atrial fibrillation, anticoagulation reduces thrombotic events but increases overall bleeding, while major bleeding risk remains comparable, emphasizing the need for individualized assessment, particularly in frail patients.

Cite This Study

Ding et al. (2024) conducted a cohort in nonvalvular atrial fibrillation (NVAF) (n=361). Anticoagulant therapy vs. No anticoagulation was evaluated on thrombotic events. In elderly patients with NVAF, anticoagulation was associated with fewer thrombotic events (6.99% vs 10.98%) but more bleeding events (20.98% vs 12.72%) compared to no anticoagulation.

synapsesocial.com/papers/6a787d579d809400dabd771ehttps://doi.org/10.2147/cia.s453527
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Also Consider

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

  1. 1Effectiveness and Safety of Anticoagulation Therapy in Frail Patients With Atrial Fibrillation2022 · 54 citations
  2. 2Epidemiology and impact of frailty in patients with atrial fibrillation in Europe2022 · 72 citations
  3. 3Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry2022 · 72 citations
  4. 4NOACs vs. Warfarin for Stroke Prevention in Nonvalvular Atrial Fibrillation2017 · 22 citations
  5. 5Age-Adjusted Charlson Comorbidity Index Predicts Survival in Endometrial Cancer Patients2022 · 68 citations