1. Clinical Characteristics and Outcomes of Very Elderly Patients With Atrial Fibrillation at High Bleeding Risk ― The Fushimi AF Registry ―
- Author
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Mitsuru Abe, Gregory Y.H. Lip, Mitsuru Ishii, Masaharu Akao, Hikari Tsuji, Akiko Fujino, Kosuke Doi, Y Ide, Syuhei Ikeda, Hiromichi Wada, Hisashi Ogawa, Masahiro Esato, Nobutoyo Masunaga, Koji Hasegawa, Yoshimori An, Yasuhiro Hamatani, Moritake Iguchi, and Kenjiro Ishigami
- Subjects
medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Original article ,Arrhythmia/Electrophysiology ,Very elderly ,Atrial fibrillation ,General Medicine ,medicine.disease ,Comorbidity ,chemistry.chemical_compound ,chemistry ,Edoxaban ,Bleeding risk ,Internal medicine ,Cohort ,Oral anticoagulant ,medicine ,Adverse effect ,business ,Stroke - Abstract
Background: The ELDERCARE-AF trial demonstrated that low-dose edoxaban prevented stroke or systemic embolism (SE) in very elderly Japanese patients with non-valvular atrial fibrillation (NVAF) in whom standard oral anticoagulant therapy was inappropriate because of high bleeding risk. The aim of this study was to elucidate the characteristics and outcomes of such patients in routine clinical practice. Methods and Results: Data were extracted from the Fushimi AF Registry for ELDERCARE-eligible NVAF patients aged ≥80 years, with a CHADS2 score ≥2 and ≥1 bleeding risk factors, as shown in the ELDERCARE-AF trial. ELDERCARE-eligible patients (n=549; 12.8% of the entire cohort, 52.9% of those aged ≥80 years and with CHADS2 score ≥2) were less often male, were older, had more comorbidity and higher risk scores than non-eligible patients from the entire cohort (n=3,734). The crude incidence (% per patient-year) of adverse events was significantly higher in ELDERCARE-eligible than non-eligible patients (stroke/SE, 4.8% vs. 2.0%; major bleeding, 3.6% vs. 1.9%; all-cause mortality, 15.5% vs. 3.9%; cardiovascular death, 2.7% vs. 0.6%; all log-rank P
- Published
- 2021
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