TY - JOUR
T1 - 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
AU - Hiasa, Ken Ichi
AU - Kaku, Hidetaka
AU - Inoue, Hiroshi
AU - Yamashita, Takeshi
AU - Akao, Masaharu
AU - Atarashi, Hirotsugu
AU - Koretsune, Yukihiro
AU - Okumura, Ken
AU - Shimizu, Wataru
AU - Ikeda, Takanori
AU - Toyoda, Kazunori
AU - Hirayama, Atsushi
AU - Yasaka, Masahiro
AU - Yamaguchi, Takenori
AU - Teramukai, Satoshi
AU - Kimura, Tetsuya
AU - Kaburagi, Jumpei
AU - Takita, Atsushi
AU - Tsutsui, Hiroyuki
PY - 2020/2/25
Y1 - 2020/2/25
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85089247363&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089247363&partnerID=8YFLogxK
U2 - 10.1253/circj.CJ-19-0898
DO - 10.1253/circj.CJ-19-0898
M3 - Article
C2 - 31969518
AN - SCOPUS:85089247363
VL - 84
SP - 388
EP - 396
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 3
ER -