Clinical Characteristics And Antithrombotic Status In 621 Very Elderly Hospitalized Patients With Atrial Fibrillation

OBJECTIVE The prevalence of atrial fibrillation(AF)increases with age and is associated with high morbidity and mortality.The main objective was to describe the clinical characteristics and antithrombotic status and the factors that determine the clinical functional strategy antithrombotic used in hospitalized elderly AF patients.METHODS Data were collected involving patients hospitalized at The First Affiliated Hospital of Shihezi Medical University during June 2015 to September 2017.RESULTS 1.Basic information,There were 621 patients with an average age 82.4±5.0 years(42.3% females;91.8% Han),The prevalence of risk factors and cardiovascular disease was high: hypertension(56.5%),heart failure(38.2%),Coronary artery disease(76.8%),Carotid atherosclerosis(21.3%).2.Stroke score:The average score of the CHA2D2S-VASc scale was3.90±1.25.The average ATRIA score of selected patients was 7.39±1.65.Among them,45(7.2%)were low-risk patients,162(26.1%)were middle-risk patients,and 414(66.7%)were high-risk patients.The average score of bleeding HAS-BLED was 2.19±0.92,the low risk was 426(68.6%),the high risk of bleeding was 195(31.4%),the average score of ORBIT was2.1±1.34,and 447(71.98%)were low risk patients,81 patients(13%)were middle-risk patients,and 93 patients(15.01%)were high-risk patients.According to the 2016 ESC atrial fibrillation guidelines,CHA2DS2-VASc is used for stroke risk scores.Oral anticoagulation drugs are recommended for men with ≥2 points and ≥3 points for women.All patients enrolled in the study were over 80 years of age with a score of ≥ 2,recommended oral anticoagulant drugs except for contraindications.respectively.Among 621 patients,35.7% of which chose oral anticoagulant therapy(OAT): warfarin(25.6%)and novel oral anticoagulants(10.1%),32.4% of patients under medication of antiplatelet therapy,and31.9% received neither warfarin nor oral anticoagulants therapy.3.Anticoagulation analysis:According to the definition of the European Guidelines for AF,CHA2DS2-VASc score was used in the stroke risk stratification,all patients with score ≥2,while the rates of OAT were 35.7%.4.Follow-up,In this study,only one follow-up was performed and 97.3%of the patients(n=604)were successful,26.6% of the patients(n =159)were died,only16.75% of the patients(n =104)continued to receive the anticoagulation treatment.Hospitalized patients older than 80 years old with NVAF showed numerous comorbidities.The percentage of Anticoagulation is scarce and only 35.7% of those received their treatment.CONCLUSION Patients with atrial fibrillation is often accompanied by a variety of comorbidities,the current proportion of anticoagulant therapy is low.