当前位置：
X-MOL 学术
›
Clin. Interventions Aging
›
论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Effects of Anticoagulant Therapy and Frailty in the Elderly Patients with Atrial Fibrillation
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-02-14 , DOI: 10.2147/cia.s453527 Jiancao Ding , Ying Sun , Kan Zhang , Wei Huang , Mei Tang , Dai Zhang , Yunli Xing
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2024-02-14 , DOI: 10.2147/cia.s453527 Jiancao Ding , Ying Sun , Kan Zhang , Wei Huang , Mei Tang , Dai Zhang , Yunli Xing
Objective: This study explored whether anticoagulation is safe for frail and non-frail elderly patients who have nonvalvular atrial fibrillation (NVAF).
Methods: At hospital discharge, the anticoagulant regimen and frailty status were recorded for 361 elderly patients (aged ≥ 75 y) with NVAF. The patients were followed for 12 months. The endpoints included occurrence of thrombosis; bleeding; all-cause death; and cardiovascular events.
Results: At hospital discharge, frailty affected 50.42% of the population and the anticoagulation rate was 44.04%. At discharge, age (OR 0.948, P = 0.006), paroxysmal NVAF (OR 0.384, P < 0.001), and bleeding history (OR 0.396, P = 0.001) were associated with a decrease in rate of receiving anticoagulation, while thrombotic events during hospitalization (OR 2.281, P = 0.021) were associated with an increase. Relative to non-frail patients, those with frailty showed a higher rate of ischemic stroke (5.33% cf. 3.01%), bleeding (P = 0.006) events, and all-cause mortality (P = 0.001). Relative to the group without anticoagulation, in those with anticoagulation the rate of thrombotic events was lower (6.99 cf. 10.98%) and bleeding events were higher (20.98 cf. 12.72%), but the risk of major bleeding was comparable.
Conclusion: In the elderly patients with NVAF, the decision toward anticoagulation therapy at hospital discharge was influenced by age, bleeding history, paroxysmal atrial fibrillation diagnosis, and absence of thrombosis. Frail patients were at greater risk of bleeding and all-cause mortality. Anticoagulation tended to reduce the risk of thrombotic events.
Keywords: elderly, non-valvular atrial fibrillation, frailty, anticoagulation
中文翻译：
老年房颤患者抗凝治疗及衰弱的影响
目的：本研究探讨抗凝治疗对于患有非瓣膜性心房颤动（NVAF）的虚弱和非虚弱老年患者是否安全。
方法：记录361例老年（≥75岁）NVAF患者出院时的抗凝治疗方案和虚弱状况。对患者进行了 12 个月的随访。终点包括血栓形成的发生；流血的;全因死亡；和心血管事件。
结果：出院时，衰弱人群占50.42%，抗凝率为44.04%。出院时，年龄（OR 0.948，P = 0.006）、阵发性 NVAF（OR 0.384，P < 0.001）和出血史（OR 0.396，P = 0.001）与接受抗凝治疗的比率降低相关，而出院期间的血栓事件住院治疗（OR 2.281，P = 0.021）与增加有关。相对于非虚弱患者，虚弱患者的缺血性卒中（5.33% 对比 3.01%）、出血（P = 0.006）事件和全因死亡率（P = 0.001）发生率更高。相对于未抗凝组，接受抗凝治疗的患者血栓事件发生率较低（6.99 比照 10.98%），出血事件发生率较高（20.98 比照 12.72%），但大出血风险相当。
结论：在老年 NVAF 患者中，出院时抗凝治疗的决定受到年龄、出血史、阵发性房颤诊断和无血栓形成的影响。体弱的患者出血和全因死亡的风险更大。抗凝往往可以降低血栓事件的风险。
【关键词】：老年 非瓣膜性房颤 衰弱 抗凝
更新日期：2024-02-14
Methods: At hospital discharge, the anticoagulant regimen and frailty status were recorded for 361 elderly patients (aged ≥ 75 y) with NVAF. The patients were followed for 12 months. The endpoints included occurrence of thrombosis; bleeding; all-cause death; and cardiovascular events.
Results: At hospital discharge, frailty affected 50.42% of the population and the anticoagulation rate was 44.04%. At discharge, age (OR 0.948, P = 0.006), paroxysmal NVAF (OR 0.384, P < 0.001), and bleeding history (OR 0.396, P = 0.001) were associated with a decrease in rate of receiving anticoagulation, while thrombotic events during hospitalization (OR 2.281, P = 0.021) were associated with an increase. Relative to non-frail patients, those with frailty showed a higher rate of ischemic stroke (5.33% cf. 3.01%), bleeding (P = 0.006) events, and all-cause mortality (P = 0.001). Relative to the group without anticoagulation, in those with anticoagulation the rate of thrombotic events was lower (6.99 cf. 10.98%) and bleeding events were higher (20.98 cf. 12.72%), but the risk of major bleeding was comparable.
Conclusion: In the elderly patients with NVAF, the decision toward anticoagulation therapy at hospital discharge was influenced by age, bleeding history, paroxysmal atrial fibrillation diagnosis, and absence of thrombosis. Frail patients were at greater risk of bleeding and all-cause mortality. Anticoagulation tended to reduce the risk of thrombotic events.
Keywords: elderly, non-valvular atrial fibrillation, frailty, anticoagulation
中文翻译：
老年房颤患者抗凝治疗及衰弱的影响
目的：本研究探讨抗凝治疗对于患有非瓣膜性心房颤动（NVAF）的虚弱和非虚弱老年患者是否安全。
方法：记录361例老年（≥75岁）NVAF患者出院时的抗凝治疗方案和虚弱状况。对患者进行了 12 个月的随访。终点包括血栓形成的发生；流血的;全因死亡；和心血管事件。
结果：出院时，衰弱人群占50.42%，抗凝率为44.04%。出院时，年龄（OR 0.948，P = 0.006）、阵发性 NVAF（OR 0.384，P < 0.001）和出血史（OR 0.396，P = 0.001）与接受抗凝治疗的比率降低相关，而出院期间的血栓事件住院治疗（OR 2.281，P = 0.021）与增加有关。相对于非虚弱患者，虚弱患者的缺血性卒中（5.33% 对比 3.01%）、出血（P = 0.006）事件和全因死亡率（P = 0.001）发生率更高。相对于未抗凝组，接受抗凝治疗的患者血栓事件发生率较低（6.99 比照 10.98%），出血事件发生率较高（20.98 比照 12.72%），但大出血风险相当。
结论：在老年 NVAF 患者中，出院时抗凝治疗的决定受到年龄、出血史、阵发性房颤诊断和无血栓形成的影响。体弱的患者出血和全因死亡的风险更大。抗凝往往可以降低血栓事件的风险。
【关键词】：老年 非瓣膜性房颤 衰弱 抗凝
京公网安备 11010802027423号