Author + information
- Meytal Avgil Tsadok,
- Cynthia Jackevicius,
- Vidal Essebag,
- Mark Eisenberg,
- Elham Rahme,
- Karin Humphries,
- Jack Tu and
- Louise Pilote
Warfarin anticoagulation is highly effective at reducing stroke risk but is associated with higher risk of bleeding. Older AF patients are at the highest risk of stroke, so they stand to benefit the most from treatment. Clinical trials for stroke prevention in AF patients usually under-represent the older population. In this study, we aimed to examine rates of warfarin use, stroke and bleeding incidence according to age groups in the real world setting of patients with AF.
We conducted a population-based cohort study of patients 65 years or older, admitted to hospital with recently diagnosed AF in 1999-2007, with linkage between hospital discharge, physicians and prescription drug claims databases. We grouped patients according to their age at AF admission. Stroke and bleeding incidence rates were estimated among the different age groups, with respect to warfarin use.
Warfarin prescriptions were dispensed less frequently with advanced age, while stroke rates and bleeding rates increased. Patients treated with warfarin had fewer stroke events compared with patients not treated with warfarin in all age groups, however, higher incidence rates of bleeding were mainly observed among patients older than 85 years.
Warfarin is underused in older patients. Patients older than 85 years who are not treated with warfarin have lower bleeding risk compared to patients who are treated with warfarin, but their risk for stroke is relatively much higher.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: AF/SVT VIII
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1237-42
- 2013 American College of Cardiology Foundation