Abstract
To clarify the effects of warfarin therapy in very old patients with non-valvular atrial fibrillation (NVAF), a post-hoc analysis was performed using the data of the J-RHYTHM Registry. A consecutive series of AF outpatients was enrolled from 158 institutions. Of 7,937 patients, 7,406 with NVAF (men, 70.8%; 69.8±10.0 years) were followed for 2 years or until an event occurred. Patients were divided into 3 age groups (<70, 70-84, and ≥85 years) and 5 subgroups according to international normalized ratio (INR; <1.6, 1.6-1.99, 2.0-2.59, 2.6-2.99, and ≥3.0). Prevalence of female sex, permanent AF, hypertension, coronary artery disease, heart failure, and history of ischemic stroke/transient ischemic attack was higher in the older groups. In the oldest group, 79.7% of patients received warfarin and their time in therapeutic range, using the Japanese target INR of 1.6-2.6, was 67.1%. Rate of thromboembolic events was lower in the age groups <70 and 70-84 years (P=0.027 and P<0.001, respectively) for patients receiving warfarin compared with those who were not. In the oldest group, the rate of thromboembolism plus major hemorrhage was lower at INR 1.6-2.59. Warfarin could have beneficial effects even in very old NVAF patients if INR is...Continue Reading
References
Aug 1, 1991·Stroke; a Journal of Cerebral Circulation·P A WolfW B Kannel
Jul 6, 1995·The New England Journal of Medicine·S C CannegieterE Briët
Mar 13, 1995·Archives of Internal Medicine·W M FeinbergR G Hart
May 10, 2001·JAMA : the Journal of the American Medical Association·A S GoD E Singer
Jun 13, 2001·JAMA : the Journal of the American Medical Association·B F GageM J Radford
Jan 30, 2002·Internal Medicine·M YasakaT Yamaguchi
Oct 1, 2005·Journal of Epidemiology·Masaki OhsawaHirotsugu Ueshima
May 26, 2006·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroshi InoueKatsusuke Yano
Jul 5, 2006·Circulation·Yoko MiyasakaTeresa S M Tsang
Aug 16, 2006·Circulation·Valentin FusterUNKNOWN Heart Rhythm Society
May 23, 2007·Circulation·Elaine M HylekSusan Regan
Aug 19, 2007·Lancet·Jonathan MantUNKNOWN Midland Research Practices Network (MidReC)
Aug 12, 2008·International Journal of Cardiology·Hiroshi InoueShiro Kamakura
Oct 16, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroshi FurushoShuichi Kaneko
Oct 29, 2008·Circulation·Stuart J ConnollyUNKNOWN ACTIVE W Investigators
Sep 5, 2009·Journal of the American College of Cardiology·Daniela PoliDomenico Prisco
Sep 19, 2009·Chest·Gregory Y H LipHarry J G M Crijns
Sep 4, 2010·Journal of the American College of Cardiology·Ricarda MarinighDeirdre A Lane
Oct 12, 2010·Journal of cardiology·Hirotsugu AtarashiUNKNOWN J-RHYTHM Registry Investigators
Mar 26, 2011·Chest·Laurent GorinGregory Y H Lip
Apr 7, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Hirotsugu AtarashiUNKNOWN J-RHYTHM Registry Investigators
Jul 28, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·UNKNOWN J-RHYTHM Registry Investigators
Dec 6, 2011·Thrombosis Research·Miyoko NaganumaNobuhisa Hagiwara
Aug 28, 2012·European Heart Journal·A John CammUNKNOWN ESC Committee for Practice Guidelines (CPG)
May 28, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroshi InoueUNKNOWN J-RHYTHM Registry Investigators
Feb 25, 2014·European Heart Journal·Sigrun HalvorsenLars Wallentin
Jun 27, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·UNKNOWN JCS Joint Working Group
Jul 1, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Masaharu AkaoUNKNOWN Fushimi AF Registry Investigators
Sep 12, 2014·Circulation·Gabriel S C YiinUNKNOWN Oxford Vascular Study
Dec 11, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Eitaro KodaniTakeshi Yamashita
Citations
Feb 19, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Takeshi YamashitaRobert P Giugliano
Mar 7, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Shinichi Goto, Shinya Goto
Jan 26, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Tomoko S KatoUNKNOWN WARCEF Investigators
Jan 29, 2016·Journal of Pharmaceutical Health Care and Sciences·Atsushi OhgushiHirotoshi Echizen
Jan 5, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Eitaro KodaniUNKNOWN J-RHYTHM Registry Investigators
Oct 2, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahiro Yasaka
Mar 11, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahiro Yasaka
Mar 24, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Eitaro KodaniUNKNOWN J-RHYTHM Registry Investigators
Apr 28, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Masaomi GohbaraKazuo Kimura
May 14, 2016·Journal of Stroke·Oh Young BangJi Hoe Heo
Dec 17, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Eitaro Kodani
Jan 26, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Hsi-Yu YuYih-Sharng Chen
Jun 24, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Yoshimi NumaoTakeshi Yamashita
Sep 14, 2016·Journal of the American Heart Association·Eitaro KodaniUNKNOWN J‐RHYTHM Registry Investigators
Oct 18, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasuo OkumuraUNKNOWN AF Ablation Frontier Registry
Jan 24, 2020·Circulation Journal : Official Journal of the Japanese Circulation Society·Ken-Ichi HiasaHiroyuki Tsutsui
Aug 5, 2020·Expert Opinion on Pharmacotherapy·Tatsuya Maruhashi, Yukihito Higashi
Aug 30, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Akinori OchiYouichi Kobayashi
Oct 7, 2017·Age and Ageing·Ying BaiGregory Y H Lip
Oct 23, 2019·Annals of Vascular Diseases·Michihisa UmetsuTakashi Kamei
Dec 2, 2020·BMC Cardiovascular Disorders·M UnverdorbenP Colonna
Feb 19, 2021·European Stroke Journal·Masahito TakagiUNKNOWN for BAT2 Investigators
Mar 21, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Kirolos BarssoumMohan Rao
Apr 8, 2018·Journal of cardiology·Hiroshi InoueAtsushi Takita