Net Clinical Benefit of Oral Anticoagulation in Very Elderly Patients with Atrial Fibrillation: a Sub-analysis from the PREFER in AF Registry

Abstrakt

BACKGROUND: Increasing age predisposes to both thromboembolic and bleeding events in patients with atrial fibrillation (AF); therefore, balancing risks and benefits of oral anticoagulation (OAC) in older populations is crucial. PURPOSE: We investigated one-year outcome with different antithrombotic approaches in very elderly AF patients (age ≥85 years). METHODS: We accessed individual patients' data from the prospective European PREFER in AF Registry, compared outcomes with and without OAC, and estimated weighted net clinical benefit in different age groups. CONCLUSIONS: Because the risk of stroke increases with age more than the risk of bleeding, the absolute benefit of OAC is highest in very elderly patients, where it by far outweighs the risk of bleeding, with the greatest net clinical benefit in such patients.