Effect of frailty on anticoagulation in elderly patients with atrial fibrillation

doi:10.11915/j.issn.1671-5403.2020.12.216

Home > Archive>Volume 19, Issue 12, 2020 >945-948. DOI:10.11915/j.issn.1671-5403.2020.12.216

Effect of frailty on anticoagulation in elderly patients with atrial fibrillation
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                        10.11915/j.issn.1671-5403.2020.12.216
                    
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                        WU Yi-TingWU Yi-Ting
Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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XING Yun-LiXING Yun-Li
Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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SUN YingSUN Ying
Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Affiliation:(Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)
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Fund Project:This work was supported by Special Funding for Clinical Medicine of Hospital Administration of Beijing Municipality (ZYLX201838),Beijing Health Care Research Fund (J 19-8), and Initiative Programs of Beijing Friendship Hospital (yyqdkt2017-6).

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Abstract:

Atrial fibrillation is the most common arrhythmia in the elderly patients. The incidence of frailty in patients with atrial fibrillation increases with age as manifested by decreased physical functional reserve, increased complications, and effect on the safety of anticoagulation therapy. Considering the high risk of embolization in elderly patients with atrial fibrillation, it is necessary, in addition to assessment of embolism, to assess frailty and individualize anticoagulation regimen. Anticoagulation should not be refused for the elderly with frailty, and the gains might be better with new oral anticoagulants. This article reviews the anticoagulation strategies in elderly patients with atrial fibrillation.

Key words:aged; atrial fibrillation; frailty; anticoagulation

Reference

[1] Oqab Z, Pournazari P, Sheldon RS.What is the impact of frailty on prescription of anticoagulation in elderly patients with atrial fibrillation? A systematic review and meta-analysis[J].J Atrial Fibrillation, 2018,10(6):1870－1870.DOI:10.4022/jafib.1870.

[2] Pulignano G, Del Sindaco D, Tinti MD, et al.Atrial fibrillation management in older heart failure patients:a complex clinical problem[J].Heart Int, 2016,11(1):e41－e49.DOI:10.5301/heartint.5000230.

[3] Kim SW, Yoon SJ, Choi JY, et al.Clinical implication of frailty assessment in older patients with atrial fibrillation[J].Archives Gerontol Geriatr, 2017,70:1－7.DOI:10.1016/j.archger.2016.12.001.

[4] Wilkinson C, Todd O, Clegg A, et al.Management of atrial fibrillation for older people with frailty:a systematic review and meta-analysis[J].Age Ageing, 2019,48(2):196－203.DOI:10.1093/ageing/afy180.

[5] Magnani JW, Wang N, Benjamin EJ, et al.Atrial fibrillation and declining physical performance in older adults:the health, aging, and body composition study[J].Circ Arrhythm Electrophysiol, 2016,9(5):e003525.DOI:10.1161/CIRCEP.115.003525.

[6] Mcgrath ER, Go AS, Chang Y, et al.Use of oral anticoagulant therapy in older adults with atrial fibrillation after acute ischemic stroke[J].J Am Geriatr Soc, 2017,65(2):241－248.DOI:10.1111/jgs.14688.

[7] Van Walraven C, Hart RG, Connolly S, et al.Effect of age on stroke prevention therapy in patients with atrial fibrillation:the atrial fibrillation investigators[J].Stroke, 2009,40(4):1410－1416.DOI:10.1161/STROKEAHA.108.526988.

[8] Mostaza JM, Jimenez MJR, Laiglesia FJR, et al.Clinical characteristics and type of antithrombotic treatment in a Spanish cohort of elderly patients with atrial fibrillation according to dependency, frailty and cognitive impairment[J].J Geriatr Cardiol, 2018,15(4):268－274.DOI:10.11909/j.issn.1671-5411.2018.04.004.

[9] Steffel J, Giugliano RP, Braunwald E, et al.Edoxaban versus warfarin in atrial fibrillation patients at risk of falling:ENGAGE AF-TIMI 48 analysis[J].J Am Coll Cardiol, 2016,68(11):1169－1178.DOI:10.1016/j.jacc.2016.06.034.

[10] Hart RG, Pearce LA, Aguilar MI.Meta-analysis:antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation[J].Annals Intern Med, 2007,146(12):857－867.DOI:10.7326/0003-4819-146-12-200706190-00007.

[11] Patti G, Lucerna M, Pecen L, et al.Thromboembolic risk, bleeding outcomes and effect of different antithrombotic strategies in very elderly patients with atrial fibrillation:a sub-analysis from the PREFER in AF (PREvention oF Thromboembolic Events-European Registry in Atrial Fibrillation)[J].J Am Heart Assoc, 2017, 6(7).DOI:10.1161/JAHA.117.005657.

[12] D Lefebvre MC, St-Onge M, Glazer-Cavanagh M, et al.The effect of bleeding risk and frailty status on anticoagulation patterns in octogenarians with atrial fibrillation:the FRAIL-AF study[J].Can J Cardiol, 2016,32(2):169－176.DOI:10.1016/j.cjca.2015.05.012.

[13] Gullón A, Formiga F, Díez-Manglano J, et al.Influence of frailty on anticoagulant prescription and clinical outcomes after 1-year follow-up in hospitalised older patients with atrial fibrillation[J].Int Emerg Med, 2019,14(1):59－69.DOI:10.1007/s11739-018-1938-3.

[14] Perera V, Bajorek BV, Matthews S, et al.The impact of frailty on the utilisation of antithrombotic therapy in older patients with atrial fibrillation[J].Age Ageing, 2009,38(2):156－162.DOI:10.1093/ageing/afn293.

[15] Friberg L, Hammar N, Ringh M, et al.Stroke prophylaxis in atrial fibrillation:who gets it and who does not? Report from the Stockholm Cohort-study on Atrial Fibrillation (SCAF-study)[J].Eur Heart J, 2006,27(16):1954－1564.DOI:10.1093/eurheartj/ehl146.

[16] Magnani G, Giugliano RP, Ruff CT, et al.Efficacy and safety of edoxaban compared with warfarin in patients with atrial fibrillation and heart failure:insights from ENGAGE AF-TIMI 48[J].Eur J Heart Fail, 2016,18(9):1153－1161.DOI:10.1002/ejhf.595.

[17] Stroke Risk in Atrial Fibrillation Working Group.Independent predictors of stroke in patients with atrial fibrillation[J].Neurology, 2007,69(6):546.DOI:10.1212/01.wnl.0000267275.68538.8d.

[18] Patti G, Mantione L, Bressi E, et al.Efficacy and safety of oral anticoagulant therapy in frail patients with atrial fibrillation[J].Monaldi Arch Chest Dis, 2018,88(2):958.DOI:10.4081/monaldi.2018.958.

[19] Sardar P, Chatterjee S, Chaudhari S, et al.New oral anti-coagulants in elderly adults:evidence from a meta-analysis of randomized trials[J].J Am Geriatr Society, 2014,62(5):857－864.DOI:10.1111/jgs.12799.

[20] Graham DJ, Reichman ME, Wernecke M, et al.Cardiovascular, bleeding, and mortality risks in elderly Medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation[J].Circulation, 2015,131(2):157－164.DOI:10.1161/CIRCULATIONAHA.114.012061.

[21] Halperin JL, Hankey GJ, Wojdyla DM, et al.Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)[J].Circulation, 2014,130(2):138－146.DOI:10.1161/CIRCULATIONAHA.113.005008.

[22] Martinez BK, Sood NA, Bunz TJ, et al.Effectiveness and safety of apixaban, dabigatran, and rivaroxaban versus warfarin in frail patients with nonvalvular atrial fibrillation[J].J Am Heart Assoc, 2018,7(8):pii:e008643.DOI:10.1161/JAHA.118.008643.

[23] Halvorsen S, Atar D, Yang H, et al.Efficacy and safety of apixaban compared with warfarin according to age for stroke prevention in atrial fibrillation:observations from the ARISTOTLE trial[J].Eur Heart J, 2014,35(28):1864－1872.DOI:10.1093/eurheartj/ehu046.

[24] Pfeilschifter W, Steinstraesser T, Paulus P, et al.Risk of long-term anticoagulation under sustained severe arterial hypertension:a translational study comparing warfarin and the new oral anti-coagulant apixaban[J].J Cereb Blood Flow Metab, 2017, 37(3):855－865.DOI:10.1177/0271678X16642443.

[25] January CT, Wann LS, Alpert JS, et al.2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation:a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society[J].Circulation, 2014,130(23):e199－267.DOI:10.1161/CIR.0000000000000041.

[26] Hankey GJ, Stevens SR, Piccini JP, et al.Intracranial hemorrhage among patients with atrial fibrillation anticoagulated with warfarin or rivaroxaban:the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation[J].Stroke, 2014,45(5):1304－1312.DOI:10.1161/STROKEAHA.113.004506.

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