Frailty and anticoagulants in older subjects with atrial fibrillation: the EUROSAF study
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F23%3A10478851" target="_blank" >RIV/00216208:11110/23:10478851 - isvavai.cz</a>
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=5iDOpOauAg" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=5iDOpOauAg</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1093/ageing/afad216" target="_blank" >10.1093/ageing/afad216</a>
Alternative languages
Result language
angličtina
Original language name
Frailty and anticoagulants in older subjects with atrial fibrillation: the EUROSAF study
Original language description
Aims: Literature regarding anticoagulants in older people affected by atrial fibrillation (AF) is limited to retrospective studies, poorly considering the importance of multidimensional frailty. The main objective of this study is to evaluate in hospitalised older persons with AF the benefit/risk ratio of the anticoagulant treatments, considering the severity of frailty, determined by the multidimensional prognostic index (MPI). Methods: In this European, multicentre, prospective study, older hospitalised patients (>= 65 years) with non-valvular AF were followed-up for 12 months. Anticoagulants' use at discharge ascertained using medical records. MPI was calculated using tools derived from comprehensive geriatric assessment, classifying participants in robust, pre-frail or frail. Mortality (primary outcome); vascular events, including ischemic heart disease or ischemic stroke, hemorrhagic stroke or gastrointestinal bleedings (secondary outcomes). Results: 2,022 participants (mean age 82.9 years; females 56.6%) were included. Compared with people not taking anticoagulants (n=823), people using vitamin K antagonists (n=450) showed a decreased risk of mortality (hazard ratio, HR=0.74; 95% CI: 0.59-0.93), more pronounced in patients using direct oral anticoagulants (DOACs) (n=749) (HR=0.46; 95% CI: 0.37-0.57). Only people taking DOACs reported a significantly lower risk of vascular events (HR=0.55; 95% CI: 0.31-0.97). The efficacy of DOACs was present independently from frailty status. The risk of gastrointestinal bleedings and hemorrhagic stroke did not differ based on the anticoagulant treatments and by MPI values. Conclusions: Anticoagulant treatment, particularly with DOACs, was associated with reduced mortality in older people, without increasing the risk of hemorrhagic events, overall suggesting the importance of treating with anticoagulants older people with AF.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30227 - Geriatrics and gerontology
Result continuities
Project
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Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Age and Ageing
ISSN
0002-0729
e-ISSN
1468-2834
Volume of the periodical
52
Issue of the periodical within the volume
11
Country of publishing house
GB - UNITED KINGDOM
Number of pages
9
Pages from-to
afad216
UT code for WoS article
001186462800009
EID of the result in the Scopus database
2-s2.0-85179481251