Frailty and Anticoagulant Therapy in Patients Aged 65 Years or Older with Atrial Fibrillation

Jiapeng Liu, Xin Du, Mengmeng Li, Zhaoxu Jia, Shangxin Lu, Sanshuai Chang, Ribo Tang, Rong Bai, Jianzeng Dong, Gregory Y H Lip, Changsheng Ma

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Abstract

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.
OriginalsprogEngelsk
TidsskriftCARDIOVASCULAR INNOVATIONS AND APPLICATIONS
Vol/bind4
Udgave nummer3
Sider (fra-til)153-161
Antal sider9
ISSN2009-8618
DOI
StatusUdgivet - 1 jan. 2020

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