Clinical Outcomes of Oral Anticoagulation in Elderly East Asian Patients with Atrial Fibrillation: A Retrospective Single-Center Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: (1) Background: Atrial fibrillation (AF) is the most common arrhythmia and poses a clinical dilemma in the very elderly due to increased thromboembolic and bleeding risks. This study aimed to evaluate clinical outcomes—including thromboembolic events, major bleeding, and all-cause mortality—by age group in elderly East Asian patients with non-valvular AF receiving oral anticoagulants. (2) Methods: This retrospective single-center study included 502 patients aged ≥70 years treated with direct oral anticoagulants (DOACs: dabigatran, rivaroxaban, edoxaban, or apixaban) or warfarin between 2016 and 2024. Patients were stratified into two age groups: 70–79 and ≥80 years. The primary outcomes were ischemic stroke, systemic thromboembolism, and major bleeding. (3) Results: Although patients aged ≥80 years showed a numerically higher incidence of bleeding in both the DOAC and warfarin groups, these differences were not statistically significant after multivariable adjustment (DOAC group: HR 0.832; 95% CI, 0.456–1.518; p = 0.549; warfarin group: HR 3.617; 95% CI, 0.600–21.804; p = 0.161). Ischemic and thromboembolic event rates were also comparable between age groups. (4) Conclusions: Despite a numerically higher bleeding risk in the very elderly, DOACs remained safe and effective when appropriately managed. These findings support individualized anticoagulation decisions based on clinical factors rather than age alone in elderly East Asian patients with AF.
Source: Life
DOI: 10.3390/life15081298
Authors: Kyunyeon Kim, YouMi Hwang, Sang-Suk Choi, Hunjoo Lee, Young-Jun Son, Myungjae Yoo
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
Funder: Catholic University of Korea
OpenAlex ID: W4413379913