Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan - Insight From the ANAFIE (All Nippon AF In Elderly) Registry

Ken Ichi Hiasa, Hidetaka Kaku, Hiroshi Inoue, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Yukihiro Koretsune, Ken Okumura, Wataru Shimizu, Takanori Ikeda, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Satoshi Teramukai, Tetsuya Kimura, Jumpei Kaburagi, Atsushi Takita, Hiroyuki Tsutsui

Research output: Contribution to journalArticlepeer-review

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Abstract

BACKGROUND: Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE Registry is a multicenter, prospective, observational registry of 32,726 non-valvular AF patients aged ≥75 years. The present study assessed the age-related differences in baseline clinical status and anticoagulant therapy between age groups 75-<80, 80-<85, 85-<90, and ≥90 years. The prevalence of persistent or permanent AF increased, and that of paroxysmal AF decreased, with increasing age (trend P<0.0001). The risk of stroke, based on CHADS2and CHA2DS2-VASc scores, and bleeding, based on HAS-BLED score, increased with age. Both warfarin and apixaban were used more often as age increased (trend P<0.0001, for each), while other anticoagulants were used less. Anticoagulant doses were significantly lower in older patients. CONCLUSIONS: Permanent/persistent AF, comorbidities, and cardiovascular and bleeding risk all increased significantly with age. Furthermore, use of warfarin and apixaban increased with age, accompanied by a decrease in other oral anticoagulant usage.

Original languageEnglish
Pages (from-to)388-396
Number of pages9
JournalCirculation journal : official journal of the Japanese Circulation Society
Volume84
Issue number3
DOIs
Publication statusPublished - Feb 25 2020

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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