Key result
Each year of aging was associated with a 3.4% increase in the risk of thromboembolic events in patients with valvular atrial fibrillation (OR 1.034).
Cohort (n=497)
Yes
In a Turkish registry of valvular AF, despite high rates of warfarin prescription, only a minority of patients achieved therapeutic INR levels, leaving them at risk for thromboembolism.
Answers are grounded in this paper and cite their sources.
May warrant age-stratified monitoring in valvular AF; leaves open whether age modifies anticoagulation efficacy in trials.
BACKGROUND: The aim of this study was to perform a multicenter, prospective investigation regarding the epidemiology, the current effectiveness of therapeutic anticoagulation, and the risk of thromboembolism in patients with valvular atrial fibrillation (AF) based on the records of the Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. METHODS: Patients were selected from a total of 2,242 consecutive admissions that presented with AF diagnosed via electrocardiogram. Those diagnosed with non-valvular AF were excluded from the AFTER study population, which left 497 patients with valvular AF for analysis. RESULTS: The etiology of valvular AF in patients was either attributed to rheumatic mitral valve stenosis (n = 217) or possessing a prosthetic heart valve (n = 280). Out of all the patients with valvular AF, 83.1% were taking warfarin for anticoagulation. Only 36.1% demonstrated a therapeutic international normalized ratio (INR), and among those patients it was found that 19.1% exhibited a labile INR. Multivariate analysis revealed that age was the only independent predictor of thromboembolic events in patients with valvular AF. CONCLUSIONS: Many valvular AF patients are not maintained at therapeutic INR levels, which poses a threat to patient health as they age and are at greater risk for thromboembolism.
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Kaya et al. (2013) conducted a cohort in Valvular atrial fibrillation (n=497). Age (per year increase) was evaluated on Thromboembolic events (stroke, transient ischemic attack, or systemic thromboembolism) (OR 1.034, 95% CI 1.009-1.059, p=0.007). Each year of aging was associated with a 3.4% increase in the risk of thromboembolic events in patients with valvular atrial fibrillation (OR 1.034).
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