Oral Anticoagulation in Very Elderly Patients With Atrial Fibrillation: A Nationwide Cohort Study

Circulation
Tze-Fan ChaoShih-Ann Chen

Abstract

Stroke prevention with oral anticoagulants (OACs) is the cornerstone for the management of atrial fibrillation (AF). However, data about the use of OACs among patients ≥90 years of age are limited. We aimed to investigate the risk of ischemic stroke and intracranial hemorrhage (ICH) and the net clinical benefit of OAC treatment for very elderly patients with AF (≥90 years of age). This study used the National Health Insurance Research Database in Taiwan. Risks of ischemic stroke and ICH were compared between 11 064 and 14 658 patients with and without AF ≥90 years of age without antithrombotic therapy from 1996 to 2011. Patients with AF (n=15 756) were divided into 3 groups (no treatment, antiplatelet agents, and warfarin), and the risks of stroke and ICH were analyzed. The risks of ischemic stroke and ICH were further compared between patients treated with warfarin and nonvitamin K antagonist OACs (NOACs) from 2012 to 2015 when NOACs were available in Taiwan. Compared with patients without AF, patients with AF had an increased risk of ischemic stroke (event number/patient number, incidence = 742/11 064, 5.75%/y versus 1399/14 658, 3.00%/y; hazard ratio, 1.93; 95% confidence interval, 1.74-2.14) and similar risk of ICH (131/11 ...Continue Reading

References

Mar 13, 2008·The Annals of Pharmacotherapy·Candice L Garwood, Tia L Corbett
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Sep 2, 2009·Annals of Internal Medicine·Daniel E SingerAlan S Go
Feb 15, 2011·American Heart Journal·Matthew B Sellers, L Kristin Newby
Feb 26, 2011·Pharmacoepidemiology and Drug Safety·Ching-Lan ChengMing Liang Lai
Nov 2, 2011·Annals of Internal Medicine·Stuart J ConnollyUNKNOWN ACTIVE (Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events) Steering Committee and Inve
Oct 22, 2013·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Cheng-Yang HsiehMing-Liang Lai
May 3, 2014·Journal of the American Geriatrics Society·Partha SardarGregory Y H Lip
Oct 18, 2014·Journal of the American College of Cardiology·Tze-Fan ChaoShih-Ann Chen
Sep 19, 2015·Journal of the American College of Cardiology·Tze-Fan ChaoShih-Ann Chen
Sep 19, 2015·Circulation·Tze-Fan ChaoShih-Ann Chen
Aug 28, 2016·European Heart Journal·Paulus KirchhofUNKNOWN ESC Scientific Document Group

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Citations

Mar 12, 2019·Journal of Cardiovascular Pharmacology·Vincenzo RussoGerardo Nigro
May 22, 2019·Journal of the American Geriatrics Society·Steven DeitelzweigGregory Y H Lip
Nov 12, 2019·Circulation. Cardiovascular Quality and Outcomes·Sachin J ShahMark H Eckman
Jan 1, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Tatjana S PotparaGregory Y H Lip
Jan 11, 2020·Journal of the American Heart Association·Huei-Kai HuangChing-Hui Loh
Apr 25, 2020·Journal of Comparative Effectiveness Research·Carmen Suárez FernándezFrancesc Formiga
Jun 11, 2020·Journal of Cardiovascular Medicine·Vincenzo De SimoneGiorgio Morando
Jul 23, 2020·European Journal of Clinical Investigation·Vincenzo RussoGerardo Nigro
Feb 3, 2019·Aging·Ameenathul M FawzyGregory Y H Lip
Jul 30, 2020·Korean Circulation Journal·Eue Keun Choi
Sep 1, 2019·Journal of Thrombosis and Thrombolysis·Z B Wojszel, A Kasiukiewicz
Aug 29, 2020·European Heart Journal. Quality of Care & Clinical Outcomes·Peter Vibe RasmussenFrederik Dalgaard
Sep 28, 2018·Geriatrics & Gerontology International·Reinhold KreutzPaul Gellert
Nov 8, 2018·Korean Circulation Journal·Boyoung JoungUNKNOWN KHRS Atrial Fibrillation Guideline Working Group
Dec 7, 2018·European Heart Journal·Ammar M KilluBernard J Gersh
Feb 17, 2019·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Stefan H HohnloserMichael Nabauer
May 3, 2019·Journal of Community Hospital Internal Medicine Perspectives·Oreoluwa Oladiran, Ifeanyi Nwosu
Sep 19, 2019·International Journal of Clinical Practice·Jérémy BarbenPatrick Manckoundia
Oct 23, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Laurent FauchierNicholas Moore
Mar 20, 2020·MMW Fortschritte der Medizin·Clemens Jilek, Thorsten Lewalter
Oct 10, 2018·Frontiers in Pharmacology·Leiliane Rodrigues MarcattoPaulo Caleb Junior Lima Santos
Jun 12, 2019·Heart and Vessels·Toshihiko NishidaUNKNOWN SAKURA AF Registry Investigators
Oct 8, 2018·Journal of Neurology·D J SeiffgeGian Marco De Marchis
Aug 24, 2019·Frontiers in Medicine·Zafraan ZatharGregory Y H Lip
Jan 7, 2020·European Heart Journal·A John CammJan Steffel
Oct 28, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michał MazurekGregory Y H Lip
Jan 19, 2020·European Journal of Clinical Investigation·Tatjana S PotparaGregory Y H Lip
Dec 25, 2019·International Journal of Stroke : Official Journal of the International Stroke Society·Maximilian I SprügelHagen B Huttner

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