Why the study?
Advancing age is a major risk factor for ischemic stroke in AF, but predictors of clinical outcomes and the impact of oral anticoagulants in very elderly (≥85 years) Chinese AF patients required evaluation.
Does oral anticoagulant therapy reduce the composite outcome of all-cause death or any thromboembolism in very elderly (≥85 years) Chinese patients with atrial fibrillation?
Does oral anticoagulant therapy reduce the composite outcome of all-cause death or any thromboembolism in very elderly (≥85 years) Chinese patients with atrial fibrillation?
In very elderly Chinese patients (≥85 years) with atrial fibrillation, oral anticoagulation is associated with significantly improved survival and reduced thromboembolic events.
Answers are grounded in this paper and cite their sources.
Supports OAC consideration in very elderly Chinese AF; extends observational data but leaves open need for RCTs.
BACKGROUND: Advancing age is a major risk factor for ischemic stroke in atrial fibrillation. We aimed to evaluate the predictors of all-cause death/any thromboembolism and the impact of oral anticoagulant on clinical outcomes in very elderly (≥85 years) Chinese atrial fibrillation patients. METHODS: The ChiOTEAF is a prospective registry proceeded in 44 sites from 20 provinces in China between October 2014 and December 2018. Outcomes of interest were all-cause mortality, any thromboembolism, major bleeding, and new onset/worsening heart failure. RESULTS: The eligible cohort for this analysis included 6416 patients and 1215 (18.9%) patients were aged ≥85 years. Only 320 (26.4%) very elderly patients were treated with oral anticoagulant, of whom 205 (64.1%) received non-vitamin K antagonist oral anticoagulants, while antiplatelet therapy was used among 642 (53.1%) very elderly patients. On multivariate analysis, the use of oral anticoagulant was an independent predictor of a lower risk of the composite outcome (OR: 0.46; 95% CI: 0.32-0.66) and all-cause death (OR: 0.47; 95% CI: 0.32-0.69) among these very elderly atrial fibrillation patients. CONCLUSIONS: Advanced age should not be a reason to withhold oral anticoagulant, since the use of oral anticoagulants is safe and improves survival.
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Guo et al. (2021) studied this question.
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