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

• 作者: Changsheng Ma Gregory Y.H.Lip Jianzeng Dong Jiapeng Liu Mengmeng Li Ribo Tang Rong Bai Sanshuai Chang Shangxin Lu Xin Du Zhaoxu Jia
• 来源期刊: Cardiovascular Innovations and Applications
• 学科: 医学
• 关键词: ATRIAL fi brillation FRAILTY ANTICOAGULANT elderly ADULTS
• 年，卷（期）: 2020,（1）
• 页码范围: 153-161
• 页数: 9页
• 分类号: R54

摘要

Background:Elderly adults with atrial fi brillation(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%confi dence 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 signifi cantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients(81.7 vs.54.9%,P<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 signifi cant impact on prescription of anticoagulants for high-risk AF patients.