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Int J Clin Exp Med. 2015 Oct 15;8(10):18721-8. eCollection 2015.

Characteristics of non-valvular atrial fibrillation patients who benefit most from anticoagulation treatment.

Author information

1
Department of Geriatrics and Gerontology, Beijing Friendship Hospital, Capital Medical University Beijing, People's Republic of China.
2
School of Biomedical Engineering, Capital Medical University Beijing, People's Republic of China.

Abstract

OBJECTIVES:

The objective was to determine who will benefit most from oral anticoagulation (OAC) for non-valvular atrial fibrillation (NVAF) patients aged ≥ 75 years.

BACKGROUND:

It was unclear whether all of NVAF aged ≥ 75 should receive OAC.

METHODS:

We recruited NVAF ≥ 75 years without QAC who were divided into three groups according to CHA2DS-VASc scores. The clinical endpoints were ischemic stroke (IS), thromboembolism (TE), or death.

RESULTS:

The patients with CHA2DS2-VASc score of 6-9 were not appropriate for anticoagulation with the highest HAS-BLED scores. CHA2DS2-VASc of 2 had little risk for IS/TE. We further divided CHA2DS2-VASc of 3-5 into three subgroups with estimated glomerular filtration rate (eGFR; ml/min/1.73 m(2)): < 30, 30-60, and > 60. The patients with eGFR < 30 had the highest bleeding risk with a comparable IS/TE.

CONCLUSIONS:

NVAF with CHA2DS2-VASc of 3-5 and eGFR > 30 ml/min/1.73 m(2) represent the most appropriate population for anticoagulation.

KEYWORDS:

Atrial fibrillation; CHA2DS2-VASc score; anticoagulation; eGFR; elderly

PMID:
26770487
PMCID:
PMC4694387

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