Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation
Jiancao Ding,1 Ying Sun,2 Kan Zhang,2 Wei Huang,2 Mei Tang,2 Dai Zhang,2 Yunli Xing2 1Department of Geriatrics, First People’s Hospital of Zigong, Sichuan, People’s Republic of China; 2Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of Ch...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-02-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/effects-of-anticoagulant-therapy-and-frailty-in-the-elderly-patients-w-peer-reviewed-fulltext-article-CIA |
| _version_ | 1797305355341922304 |
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| author | Ding J Sun Y Zhang K Huang W Tang M Zhang D Xing Y |
| author_facet | Ding J Sun Y Zhang K Huang W Tang M Zhang D Xing Y |
| author_sort | Ding J |
| collection | DOAJ |
| description | Jiancao Ding,1 Ying Sun,2 Kan Zhang,2 Wei Huang,2 Mei Tang,2 Dai Zhang,2 Yunli Xing2 1Department of Geriatrics, First People’s Hospital of Zigong, Sichuan, People’s Republic of China; 2Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Yunli Xing, Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, People’s Republic of China, Tel +86 13121181469, Fax +86 10 6313 8040, Email xingyunli1976@126.comObjective: This study explored whether anticoagulation is safe for frail and non-frail elderly patients who have nonvalvular atrial fibrillation (NVAF).Methods: At hospital discharge, the anticoagulant regimen and frailty status were recorded for 361 elderly patients (aged ≥ 75 y) with NVAF. The patients were followed for 12 months. The endpoints included occurrence of thrombosis; bleeding; all-cause death; and cardiovascular events.Results: At hospital discharge, frailty affected 50.42% of the population and the anticoagulation rate was 44.04%. At discharge, age (OR 0.948, P = 0.006), paroxysmal NVAF (OR 0.384, P < 0.001), and bleeding history (OR 0.396, P = 0.001) were associated with a decrease in rate of receiving anticoagulation, while thrombotic events during hospitalization (OR 2.281, P = 0.021) were associated with an increase. Relative to non-frail patients, those with frailty showed a higher rate of ischemic stroke (5.33% cf. 3.01%), bleeding (P = 0.006) events, and all-cause mortality (P = 0.001). Relative to the group without anticoagulation, in those with anticoagulation the rate of thrombotic events was lower (6.99 cf. 10.98%) and bleeding events were higher (20.98 cf. 12.72%), but the risk of major bleeding was comparable.Conclusion: In the elderly patients with NVAF, the decision toward anticoagulation therapy at hospital discharge was influenced by age, bleeding history, paroxysmal atrial fibrillation diagnosis, and absence of thrombosis. Frail patients were at greater risk of bleeding and all-cause mortality. Anticoagulation tended to reduce the risk of thrombotic events.Keywords: elderly, non-valvular atrial fibrillation, frailty, anticoagulation |
| first_indexed | 2024-03-08T00:25:36Z |
| format | Article |
| id | doaj.art-3f35cdd1017e435484dd0b3c1bffc449 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-03-08T00:25:36Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-3f35cdd1017e435484dd0b3c1bffc4492024-02-15T19:18:26ZengDove Medical PressClinical Interventions in Aging1178-19982024-02-01Volume 1924725490473Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial FibrillationDing JSun YZhang KHuang WTang MZhang DXing YJiancao Ding,1 Ying Sun,2 Kan Zhang,2 Wei Huang,2 Mei Tang,2 Dai Zhang,2 Yunli Xing2 1Department of Geriatrics, First People’s Hospital of Zigong, Sichuan, People’s Republic of China; 2Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Yunli Xing, Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, People’s Republic of China, Tel +86 13121181469, Fax +86 10 6313 8040, Email xingyunli1976@126.comObjective: This study explored whether anticoagulation is safe for frail and non-frail elderly patients who have nonvalvular atrial fibrillation (NVAF).Methods: At hospital discharge, the anticoagulant regimen and frailty status were recorded for 361 elderly patients (aged ≥ 75 y) with NVAF. The patients were followed for 12 months. The endpoints included occurrence of thrombosis; bleeding; all-cause death; and cardiovascular events.Results: At hospital discharge, frailty affected 50.42% of the population and the anticoagulation rate was 44.04%. At discharge, age (OR 0.948, P = 0.006), paroxysmal NVAF (OR 0.384, P < 0.001), and bleeding history (OR 0.396, P = 0.001) were associated with a decrease in rate of receiving anticoagulation, while thrombotic events during hospitalization (OR 2.281, P = 0.021) were associated with an increase. Relative to non-frail patients, those with frailty showed a higher rate of ischemic stroke (5.33% cf. 3.01%), bleeding (P = 0.006) events, and all-cause mortality (P = 0.001). Relative to the group without anticoagulation, in those with anticoagulation the rate of thrombotic events was lower (6.99 cf. 10.98%) and bleeding events were higher (20.98 cf. 12.72%), but the risk of major bleeding was comparable.Conclusion: In the elderly patients with NVAF, the decision toward anticoagulation therapy at hospital discharge was influenced by age, bleeding history, paroxysmal atrial fibrillation diagnosis, and absence of thrombosis. Frail patients were at greater risk of bleeding and all-cause mortality. Anticoagulation tended to reduce the risk of thrombotic events.Keywords: elderly, non-valvular atrial fibrillation, frailty, anticoagulationhttps://www.dovepress.com/effects-of-anticoagulant-therapy-and-frailty-in-the-elderly-patients-w-peer-reviewed-fulltext-article-CIAelderlynon-valvular atrial fibrillationfrailtyanticoagulation |
| spellingShingle | Ding J Sun Y Zhang K Huang W Tang M Zhang D Xing Y Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation Clinical Interventions in Aging elderly non-valvular atrial fibrillation frailty anticoagulation |
| title | Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation |
| title_full | Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation |
| title_fullStr | Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation |
| title_full_unstemmed | Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation |
| title_short | Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation |
| title_sort | effects of anticoagulant therapy and frailty in the elderly patients with atrial fibrillation |
| topic | elderly non-valvular atrial fibrillation frailty anticoagulation |
| url | https://www.dovepress.com/effects-of-anticoagulant-therapy-and-frailty-in-the-elderly-patients-w-peer-reviewed-fulltext-article-CIA |
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