| Title | Anticoagulant Benefits for Atrial Fibrillation Decrease With Age | |
| Date | Wednesday November 13 2019, @09:25PM | |
| Author | janrinok | |
| Topic | ||
| from the fun-of-growing-old dept. | ||
Arthur T Knackerbracket has found the following story:
The net clinical benefit of anticoagulants for atrial fibrillation (AF) -- one of the most important causes of irregular heartbeats and a leading cause of stroke -- decreases with age, as the risk of death from other factors diminishes their benefit in older patients, according to a study led by researchers at UC San Francisco.
The multi-institutional study of nearly 15,000 AF patients found that the anticoagulant warfarin was not beneficial after age 87 and another, apixaban, after age 92. As a result, physicians should consider all mortality risks, such as cancer and end-stage kidney disease, when recommending anticoagulants to older adults with AF, the researchers said.
[...] "Many prior studies looking at the benefit of blood thinners found older adults benefit more than younger adults, but they narrowly focus on atrial fibrillation and strokes and don't account for all other health conditions affecting older adults," said lead author Sachin Shah, MD, MPH, assistant professor of medicine at UCSF. "Our study is the first to find that when taking these factors into consideration, anticoagulant benefit actually decreases with age."
Atrial fibrillation affects an estimated 2.2 million Americans, according to the National Stroke Association, and about 15 percent of people who have strokes have AF. The stroke association estimates that up to 80 percent of strokes among people with AF could have been prevented.
While patients age 75 and older are at higher risk for stroke and advised to use anticoagulants, there is little evidence of their net benefit in this population. Advancing age also increases the likelihood of death from non-AF causes, thereby limiting the benefit or harm from AF and anticoagulant treatment.
Journal Reference:
Sachin J. Shah, Daniel E. Singer, Margaret C. Fang, Kristi Reynolds, Alan S. Go, Mark H. Eckman. Net Clinical Benefit of Oral Anticoagulation Among Older Adults With Atrial Fibrillation. Circulation: Cardiovascular Quality and Outcomes, 2019; 12 (11) DOI: 10.1161/CIRCOUTCOMES.119.006212
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