%0 Journal Article
%T Patient Outcomes in Very Elderly Patients With Non-Valvular Atrial Fibrillation　- ANAFIE Registry.
%A Suzuki S
%A Yamashita T
%A Akao M
%A Atarashi H
%A Ikeda T
%A Okumura K
%A Koretsune Y
%A Shimizu W
%A Tsutsui H
%A Toyoda K
%A Hirayama A
%A Yasaka M
%A Yamaguchi T
%A Teramukai S
%A Morishima Y
%A Fukuzawa M
%A Takita A
%A Inoue H
%J Circ Rep
%V 6
%N 8
%D 2024 Aug 9
%M 39132332
暂无%R 10.1253/circrep.CR-24-0061
%X <B>UNASSIGNED: </B>The All Nippon Atrial Fibrillation In the Elderly Registry provides real-world insights into non-valvular atrial fibrillation (NVAF) in >30,000 elderly Japanese patients (aged ≥75 years), including >2,000 nonagenarians. We aimed to investigate outcomes in these patients by age and oral anticoagulant (OAC) type.<BR><B>UNASSIGNED: </B>This prospective, multicenter, observational, cohort, 2-year follow-up study included elderly patients with NVAF who were able to attend hospital visits. The incidences of stroke/systemic embolic events (SEE), major bleeding, intracranial hemorrhage (ICH), cardiovascular death, all-cause death, and major adverse cardiovascular or neurological events (MACNE) were evaluated by age. Incidence rates increased significantly with age. Stroke/SEE, major bleeding, and ICH incidences plateaued in patients aged ≥90 years. Direct OACs (DOACs) yielded a numerically lower event incidence vs. warfarin in all age groups and endpoints, except for major bleeding in patients aged ≥90 years. DOACs (vs. warfarin) were significantly associated with a lower risk of stroke/SEE, major bleeding, and ICH in the ≥80-<85 years group, and reduced cardiovascular and all-cause death in the ≥75-<80 years group. In the ≥90 years subgroup, major bleeding history was a risk factor for all-cause death.<BR><B>UNASSIGNED: </B>Although DOAC vs. warfarin offers potential benefits for stroke prevention, limitations occurred in reducing major bleeding among those aged ≥90 years, indicating a potential benefit of very-low-dose DOAC for this demographic.