TY - JOUR
T1 - Frailty and Anticoagulant Therapy in Patients Aged 65 Years or Older with Atrial Fibrillation
AU - Liu, Jiapeng
AU - Du, Xin
AU - Li, Mengmeng
AU - Jia, Zhaoxu
AU - Lu, Shangxin
AU - Chang, Sanshuai
AU - Tang, Ribo
AU - Bai, Rong
AU - Dong, Jianzeng
AU - Lip, Gregory Y H
AU - Ma, Changsheng
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Elderly adults with atrial fibrillation (AF) are at increased risk of frailty and thromboembolic complications. However, studies on the prevalence of frailty in AF patients and data on the relationship between frailty and the use of anticoagulants are limited. Methods: We conducted a cross-sectional study involving 500 participants. Patients aged 65 years or older were consecutively selected from the Chinese Atrial Fibrillation Registry study. The patient's frailty status was assessed with use of the Canadian Study of Health and Aging Clinical Frailty Scale. We assessed the prevalence of and factors associated with frailty, and how frailty affects anticoagulant therapy. Results: In 500 elderly adults with AF (age 75.2 +/- 6.7 years; 51.6% female), 201 patients (40.2%) were frail. The prevalence of frailty was higher in females (P = 0.002) and increased with age and CHA(2)DS(2)-VASc score (P for trend less than 0.001 for both). The factors associated with frailty were a history of heart failure (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.39-4.14), female sex (OR 2.09, 95% CI 1.27-3.43), and advanced age (OR 1.13, 95% CI 1.09-1.17). Frail patients were significantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients (81.7 vs. 54.9%, P textless 0.001). Conclusions: Frailty is prevalent in elderly adults with AF, especially in females, those of advanced age, and those with heart failure. Frailty status has a significant impact on prescription of anticoagulants for high-risk AF patients.
AB - Background: Elderly adults with atrial fibrillation (AF) are at increased risk of frailty and thromboembolic complications. However, studies on the prevalence of frailty in AF patients and data on the relationship between frailty and the use of anticoagulants are limited. Methods: We conducted a cross-sectional study involving 500 participants. Patients aged 65 years or older were consecutively selected from the Chinese Atrial Fibrillation Registry study. The patient's frailty status was assessed with use of the Canadian Study of Health and Aging Clinical Frailty Scale. We assessed the prevalence of and factors associated with frailty, and how frailty affects anticoagulant therapy. Results: In 500 elderly adults with AF (age 75.2 +/- 6.7 years; 51.6% female), 201 patients (40.2%) were frail. The prevalence of frailty was higher in females (P = 0.002) and increased with age and CHA(2)DS(2)-VASc score (P for trend less than 0.001 for both). The factors associated with frailty were a history of heart failure (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.39-4.14), female sex (OR 2.09, 95% CI 1.27-3.43), and advanced age (OR 1.13, 95% CI 1.09-1.17). Frail patients were significantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients (81.7 vs. 54.9%, P textless 0.001). Conclusions: Frailty is prevalent in elderly adults with AF, especially in females, those of advanced age, and those with heart failure. Frailty status has a significant impact on prescription of anticoagulants for high-risk AF patients.
U2 - 10.15212/CVIA.2019.0562
DO - 10.15212/CVIA.2019.0562
M3 - Journal article
SN - 2009-8618
VL - 4
SP - 153
EP - 161
JO - CARDIOVASCULAR INNOVATIONS AND APPLICATIONS
JF - CARDIOVASCULAR INNOVATIONS AND APPLICATIONS
IS - 3
ER -