Author + information
- Malini Madhavana,b,
- DaJuanicia Simona,b,
- Jonathan Piccinia,b,
- Jack Ansella,b,
- Gregg Fonarowa,b,
- Alan S. Goa,b,
- Elaine Hyleka,b,
- Peter Koweya,b,
- Kenneth Mahaffeya,b,
- Laine Thomasa,b,
- Eric Petersona,b and
- Bernard Gersha,b
Background: The incidence of frailty increases with age and may impact both therapy and outcomes in atrial fibrillation (AF).
Methods: We examined the prevalence of frailty (defined by the American Geriatric Society Criteria) in the Outcomes Registry for Better Informed Care in AF (ORBIT AF) and associated adjusted outcomes via multivariable Cox regression.
Results: Among 9722 patients with AF [median (IQR) age 75 (67 – 82) y, 58% male], frailty was identified in 575 (5.9%) at baseline. Frail patients with AF were less likely to receive an oral anticoagulant (OAC) (68 vs 77%, p<0.001) despite a higher median CHA2DS2VASc score [5 (4 – 6) vs 4.0 (3 – 5), p<0.001]. Using multivariable cox regression, frailty was associated with increased incidence of death [HR 1.32 (1.11-1.57), p=0.0017], but not stroke / TIA or major bleeding. Mortality in frail and non-frail AF patients stratified by OAC use (unadjusted analysis) is presented in Figure. In multivariable analysis, there was no interaction between OAC use and frailty in predicting mortality, major bleeding and composite end point of stroke, TIA, MI or cardiovascular death.
Conclusions: While frailty in AF was associated with increased mortality, the benefits of OAC were similar in frail patients or those not.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Specific Situations and Newer Outcome Measures
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1190-096
- 2017 American College of Cardiology Foundation