Key result
Elderly patients (≥80 years) with atrial fibrillation had a higher prevalence of stroke or systemic emboli compared to younger patients (25.6% vs 14.7%, P<0.001).
Why the study?
AF prevalence increases with age, making elderly patients a vulnerable cohort for higher stroke and bleeding complications.
Observational (n=2,163)
Yes
Absolute Event Rate: 25.6% vs 14.7%
p-value: p=< 0.001
Elderly Middle Eastern patients with atrial fibrillation have a higher burden of comorbidities and stroke risk, but are appropriately prescribed guideline-directed oral anticoagulants at rates similar to younger patients.
Elderly Middle Eastern AF patients show higher-risk profiles; leaves open whether region-specific strategies improve outcomes.
Background: Atrial fibrillation (AF) is the most common arrhythmia that is associated with high morbidity and mortality. The prevalence of AF increases with age and the elderly constitute a vulnerable cohort for higher stroke and bleeding complications. Methods: A total of 2163 adult consecutive patients with AF in 19 hospitals and 11 outpatient clinics in Jordan were enrolled in the Jordan AF study from May 2019 to January 2021. The clinical characteristics, demographics, and risk profiles of the elderly patients ( ≥ 80 years old) were compared to the younger patients (< 80 years old). Results: Of 2163 patients, 379 (17.5%) constituted the elderly group. The elderly group had higher prevalence of hypertension (79.9% vs 73.5%, p=0.01), lower prevalence of smoking (5.0% vs 15.2%, p< 0.001) and lower body mass index (28.1 ± 5.5 kg/m 2 vs 29.8 ± 6.2 kg/m 2 , p< 0.001) compared with younger patients. They also had more strokes or systemic emboli (25.6% vs 14.7%, p< 0.001), heart failure (30.3% vs 22.9%, p=0.002), pulmonary hypertension (30.6% vs 24.8%, p=0.02), and chronic kidney disease (13.5% vs 8.3%, p=0.002). The elderly cohort had higher mean CHA2DS2-VASc (5.0 ± 1.5 vs 3.6 ± 1.8, p< 0.001) and HAS-BLED scores (2.2 ± 1.1 vs 1.5 ± 1.1, p< 0.001) compared to younger group. Among 370 elderly with non-valvular AF (NVAF), oral anticoagulant agents (OACs) were prescribed for 278 (84.2%) of eligible high-risk patients. Of the 1402 younger patients with NVAF, OACs were prescribed for 1133 (84.3%) of eligible patients. Direct oral anticoagulant agents (DOACs) were more frequently used in the elderly compared to the young (72.3% vs 62.3%, p< 0.001). Conclusion: Elderly Middle Eastern AF patients have worse baseline clinical profiles and higher risk scores compared to younger patients. The majority of the elderly were prescribed guideline directed OACs, with higher use of DOACs than the younger cohort. Clinical Studies Registration: The study is registered on clinicaltrials.gov (unique identifier number NCT03917992).
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A 2022 study conducted an observational in Atrial fibrillation (n=2,163). Elderly age (≥ 80 years) vs. Younger age (< 80 years) was evaluated on Stroke or systemic emboli (p=< 0.001). Elderly patients (≥80 years) with atrial fibrillation had a higher prevalence of stroke or systemic emboli compared to younger patients (25.6% vs 14.7%, P<0.001).
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