Risc of hemorrhage in patients older than 85 years, anticoagulated due to atrial fibrillation

Background: Atrial fibrillation is the most common cardiac tachyarrythmia and is an important independent risk factor for ischemic stroke. Its prevalence begins to increase in both sexes after 40 years of age as well as the risk of hemorrhage. The aim of this study was to compare the annual rate of...

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Autores principales: Revigliono, José I., Amuchastegui, Tomás, Contreras, Alejandro E., Amuchastegui, Marcos
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2011
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/21509
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Sumario:Background: Atrial fibrillation is the most common cardiac tachyarrythmia and is an important independent risk factor for ischemic stroke. Its prevalence begins to increase in both sexes after 40 years of age as well as the risk of hemorrhage. The aim of this study was to compare the annual rate of hemorrhagic events between patients older and younger than 85 years, with diagnosis of nonvalvular atrial fibrillation and anticoagulated with warfarin. Material and methods: A retrospective study was performed. We included 118 patients with diagnosis of nonvalvular atrial fibrillation monitorized by an informatized follow up system. Results: The study follow-up was 28,2 ±17,5 months and 24 patients (20,3%) were older than 85 years of age. The rate of major bleedings was 4,62%/year (older than 85 years) vs 0,95%/year (younger than 85 years) , p= 0,05, OR 6,57 (IC 95% 1,04-41,8) and minor bleeding was 4,62%/year (older than 85 years) vs 5,2%/year (younger than 85 years), p=0,99, OR 1,08 (IC 95% 0,28-4,21). There was no difference in the Time in Therapeutic Range between both groups (56.4 ± 16.3 % vs 60.5 ± 17.7 %, p 0,30). Conclusion: The age should not be considered a contraindication to anticoagulant therapy, however, special care and careful monitoring of patients older than 85 years should be considered due to they had high risk of bleeding.