Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry

Rungroj Krittayaphong,1 Thanita Boonyapiphat,2 Chaiyasith Wongvipaporn,3 Poom Sairat1 On behalf of the COOL-AF Investigators1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Division of Cardiology, Department of Medicine, L...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Krittayaphong R, Boonyapiphat T, Wongvipaporn C, Sairat P
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
Acceso en línea:https://doaj.org/article/d33bd1df29a74923982eb00b2b71dfc2
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:d33bd1df29a74923982eb00b2b71dfc2
record_format dspace
spelling oai:doaj.org-article:d33bd1df29a74923982eb00b2b71dfc22021-12-02T14:52:06ZAge-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry1178-1998https://doaj.org/article/d33bd1df29a74923982eb00b2b71dfc22021-04-01T00:00:00Zhttps://www.dovepress.com/age-related-clinical-outcomes-of-patients-with-non-valvular-atrial-fib-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Rungroj Krittayaphong,1 Thanita Boonyapiphat,2 Chaiyasith Wongvipaporn,3 Poom Sairat1 On behalf of the COOL-AF Investigators1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Division of Cardiology, Department of Medicine, Lampang Hospital, Lampang, Thailand; 3Division of Cardiology, Department of Medicine,Srinakarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Rungroj KrittayaphongDivision of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, ThailandTel +66 2-419-6104Fax +66 2-412-7412Email rungroj.kri@mahidol.ac.thPurpose: We aimed to compare the rate of clinical outcomes among three age groups (< 65, 65– 74, and ≥ 75 years) of adult patients with non-valvular atrial fibrillation (NVAF).Patients and Methods: We prospectively enrolled NVAF patients from 27 Thailand medical centers. The following were collected at baseline: demographic data, risk factors, comorbid conditions, laboratory data, and medications. The clinical outcomes were ischemic stroke (IS) or transient ischemic attack (TIA), major bleeding (MB), intracerebral hemorrhage (ICH), heart failure (HF), and death. All events were adjudicated. Patients were categorized according to age group into three groups; age < 65, 65– 74, and ≥ 75 years.Results: Among the 3402 patients that were enrolled during 2014– 2017, the mean age was 67.4± 11.3 years, and 2073 (60.9%) were older. The average follow-up was 25.7± 10.6 months. Oral anticoagulants were given in 75.4% of patients (91.1% of OAC was warfarin). The incidence rate of IS/TIA, MB, ICH, HF, and death was 1.43 (1.17– 1.74), 2.11 (1.79– 2.48), 0.70 (0.52– 0.92), 3.03 (2.64– 3.46), and 3.77 (3.33– 4.24) per 100 person-years, respectively. The risk of IS/TIA, MB, ICH, HF, and death increased with age both before and after adjustment for potential confounders. Even though OAC reduced the risk of IS/TIA, it increased the risk of MB. Net clinical benefit (NCB) analysis favored oral anticoagulant (OAC) in the high-risk subset of older adults.Conclusion: Older adult NVAF patients had a significantly increased risk of IS/TIA, MB, ICH, HF, and death compared to younger NVAF before and after adjustment for potential confounders. Strategies to reduce overall risk, including OAC use and choice and integrated care, should be implemented.Keywords: age-related clinical outcomes, patients, non-valvular atrial fibrillation, NVAF, COOL-AF registry, ThailandKrittayaphong RBoonyapiphat TWongvipaporn CSairat PDove Medical Pressarticleage-related clinical outcomespatientsnon-valvular atrial fibrillationnvafcool-af registrythailandGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 707-719 (2021)
institution DOAJ
collection DOAJ
language EN
topic age-related clinical outcomes
patients
non-valvular atrial fibrillation
nvaf
cool-af registry
thailand
Geriatrics
RC952-954.6
spellingShingle age-related clinical outcomes
patients
non-valvular atrial fibrillation
nvaf
cool-af registry
thailand
Geriatrics
RC952-954.6
Krittayaphong R
Boonyapiphat T
Wongvipaporn C
Sairat P
Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
description Rungroj Krittayaphong,1 Thanita Boonyapiphat,2 Chaiyasith Wongvipaporn,3 Poom Sairat1 On behalf of the COOL-AF Investigators1Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; 2Division of Cardiology, Department of Medicine, Lampang Hospital, Lampang, Thailand; 3Division of Cardiology, Department of Medicine,Srinakarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCorrespondence: Rungroj KrittayaphongDivision of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, ThailandTel +66 2-419-6104Fax +66 2-412-7412Email rungroj.kri@mahidol.ac.thPurpose: We aimed to compare the rate of clinical outcomes among three age groups (< 65, 65– 74, and ≥ 75 years) of adult patients with non-valvular atrial fibrillation (NVAF).Patients and Methods: We prospectively enrolled NVAF patients from 27 Thailand medical centers. The following were collected at baseline: demographic data, risk factors, comorbid conditions, laboratory data, and medications. The clinical outcomes were ischemic stroke (IS) or transient ischemic attack (TIA), major bleeding (MB), intracerebral hemorrhage (ICH), heart failure (HF), and death. All events were adjudicated. Patients were categorized according to age group into three groups; age < 65, 65– 74, and ≥ 75 years.Results: Among the 3402 patients that were enrolled during 2014– 2017, the mean age was 67.4± 11.3 years, and 2073 (60.9%) were older. The average follow-up was 25.7± 10.6 months. Oral anticoagulants were given in 75.4% of patients (91.1% of OAC was warfarin). The incidence rate of IS/TIA, MB, ICH, HF, and death was 1.43 (1.17– 1.74), 2.11 (1.79– 2.48), 0.70 (0.52– 0.92), 3.03 (2.64– 3.46), and 3.77 (3.33– 4.24) per 100 person-years, respectively. The risk of IS/TIA, MB, ICH, HF, and death increased with age both before and after adjustment for potential confounders. Even though OAC reduced the risk of IS/TIA, it increased the risk of MB. Net clinical benefit (NCB) analysis favored oral anticoagulant (OAC) in the high-risk subset of older adults.Conclusion: Older adult NVAF patients had a significantly increased risk of IS/TIA, MB, ICH, HF, and death compared to younger NVAF before and after adjustment for potential confounders. Strategies to reduce overall risk, including OAC use and choice and integrated care, should be implemented.Keywords: age-related clinical outcomes, patients, non-valvular atrial fibrillation, NVAF, COOL-AF registry, Thailand
format article
author Krittayaphong R
Boonyapiphat T
Wongvipaporn C
Sairat P
author_facet Krittayaphong R
Boonyapiphat T
Wongvipaporn C
Sairat P
author_sort Krittayaphong R
title Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
title_short Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
title_full Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
title_fullStr Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
title_full_unstemmed Age-Related Clinical Outcomes of Patients with Non-Valvular Atrial Fibrillation: Insights from the COOL-AF Registry
title_sort age-related clinical outcomes of patients with non-valvular atrial fibrillation: insights from the cool-af registry
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/d33bd1df29a74923982eb00b2b71dfc2
work_keys_str_mv AT krittayaphongr agerelatedclinicaloutcomesofpatientswithnonvalvularatrialfibrillationinsightsfromthecoolafregistry
AT boonyapiphatt agerelatedclinicaloutcomesofpatientswithnonvalvularatrialfibrillationinsightsfromthecoolafregistry
AT wongvipapornc agerelatedclinicaloutcomesofpatientswithnonvalvularatrialfibrillationinsightsfromthecoolafregistry
AT sairatp agerelatedclinicaloutcomesofpatientswithnonvalvularatrialfibrillationinsightsfromthecoolafregistry
_version_ 1718389477790973952