Meta-analysis of Safety and Efficacy of Anticoagulation versus no Anticoagulation in Octogenarians and Nonagenarians with Atrial Fibrillation

Barssoum, Kirolos; Kumar, Ashish; Thakkar, Samarthkumar; Sheth, Aakash; Kharsa, Adnan; Ibrahim, Mounir; Rai, Devesh; Idemudia, Osarenren; Akula, Navya; Patel, Harsh; Mowafy, Ahmed; Elkaryoni, Ahmed; Ibrahim, Fadi; Mubasher, Mahmood; Ghattas, Kyrillos N; Rao, Mohan

doi:10.1007/s40292-021-00442-0

High Blood Press Cardiovasc Prev

2021

DOI: 10.1007/s40292-021-00442-0

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Meta-analysis of Safety and Efficacy of Anticoagulation versus no Anticoagulation in Octogenarians and Nonagenarians with Atrial Fibrillation

Kirolos Barssoum

Ashish Kumar

Samarthkumar Thakkar

et al.

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2024

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Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―

Suzuki,

Yamashita,

Akao

et al. 2024

Circ Rep

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Background The All Nippon Atrial Fibrillation In the Elderly Registry provides real-world insights into non-valvular atrial fibrillation (NVAF) in >30,000 elderly Japanese patients (aged ≥75 years), including >2,000 nonagenarians. We aimed to investigate outcomes in these patients by age and oral anticoagulant (OAC) type. Methods and Results This prospective, multicenter, observational, cohort, 2-year follow-up study included elderly patients with NVAF who were able to attend hospital visits. The incidences of stroke/systemic embolic events (SEE), major bleeding, intracranial hemorrhage (ICH), cardiovascular death, all-cause death, and major adverse cardiovascular or neurological events (MACNE) were evaluated by age. Incidence rates increased significantly with age. Stroke/SEE, major bleeding, and ICH incidences plateaued in patients aged ≥90 years. Direct OACs (DOACs) yielded a numerically lower event incidence vs. warfarin in all age groups and endpoints, except for major bleeding in patients aged ≥90 years. DOACs (vs. warfarin) were significantly associated with a lower risk of stroke/SEE, major bleeding, and ICH in the ≥80–<85 years group, and reduced cardiovascular and all-cause death in the ≥75–<80 years group. In the ≥90 years subgroup, major bleeding history was a risk factor for all-cause death. Conclusions Although DOAC vs. warfarin offers potential benefits for stroke prevention, limitations occurred in reducing major bleeding among those aged ≥90 years, indicating a potential benefit of very-low-dose DOAC for this demographic.

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Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―

Suzuki,

Yamashita,

Akao

et al. 2024

Circ Rep

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show abstract

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Meta-analysis of Safety and Efficacy of Anticoagulation versus no Anticoagulation in Octogenarians and Nonagenarians with Atrial Fibrillation

Cited by 1 publication

References 32 publications

Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―

Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―

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Meta-analysis of Safety and Efficacy of Anticoagulation versus no Anticoagulation in Octogenarians and Nonagenarians with Atrial Fibrillation

Cited by 1 publication

References 32 publications

Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation ― ANAFIE Registry ―

Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation ― ANAFIE Registry ―

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Product

Resources

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Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―

Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　― ANAFIE Registry ―