Frailty and anticoagulants in older subjects with atrial fibrillation: the EUROSAF study

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Frailty and anticoagulants in older subjects with atrial fibrillation: the EUROSAF study

Popis výsledku v původním jazyce

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 (&gt;= 65 years) with non-valvular AF were followed-up for 12 months. Anticoagulants&apos; 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.

Název v anglickém jazyce

Frailty and anticoagulants in older subjects with atrial fibrillation: the EUROSAF study

Popis výsledku anglicky

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 (&gt;= 65 years) with non-valvular AF were followed-up for 12 months. Anticoagulants&apos; 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30227 - Geriatrics and gerontology

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2023

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Age and Ageing

ISSN

0002-0729

e-ISSN

1468-2834

Svazek periodika

52

Číslo periodika v rámci svazku

11

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

9

Strana od-do

afad216

Kód UT WoS článku

001186462800009

EID výsledku v databázi Scopus

2-s2.0-85179481251