ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2022
Impact of oral anticoagulation on the association between frailty and clinical outcomes in people with atrial fibrillation: nationwide primary care records on treatment analysis.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 26 citations in OpenAlex.
- Impact of frailty on outcomes in atrial fibrillation and HFpEF: data from the TOPCAT trial.BMC cardiovascular disorders · 2026Trial
- Discontinuation of oral anticoagulants is common after catheter ablation in older patients with atrial fibrillation.European heart journal open · 2026Article
- History of falls in patients with atrial fibrillation and risk of major outcomes: analysis from the Prospective GLORIA-AF Registry.GeroScience · 2026Article
- Frailty and Cardiovascular Risk.European cardiology · 2026Review
- Sarcopenia in atrial fibrillation: a risk factor for adverse outcomes in a UK Biobank study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Frailty and stroke: Global implications for assessment, research, and clinical care-A WSO scientific statement.International journal of stroke : official journal of the International Stroke Society · 2025Review
- Stroke Risk Stratification in Incident Atrial Fibrillation: A Sex-Specific Evaluation of CHA2DS2-VA and CHA2DS2-VASc.Journal of cardiovascular development and disease · 2025Article
- What happens to conservatively managed chronic subdural haematoma.Acta neurochirurgica · 2025Article
- Impact of frailty on outcomes of elderly patients with atrial fibrillation: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- CHA2DS2-VA instead of CHA2DS2-VASc for stroke risk stratification in patients with atrial fibrillation: not just a matter of sex.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- The NORwegian atrial fibrillation self-SCREENing (NORSCREEN) trial: rationale and design of a randomized controlled trial.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Actioning atrial fibrillation identified by ambulance services in England: a qualitative exploration.BMJ open · 2024Article
- Atrial fibrillation accelerates functional decline in older adults: a 15-year follow-up population-based study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Multimorbidity in patients with atrial fibrillation.Open heart · 2024Review
- Impact of frailty on the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a nationwide cohort study.European heart journal. Quality of care & clinical outcomes · 2024Article
- Direct Oral Anticoagulants in Special Patient Populations.Journal of clinical medicine · 2023Review
- Temporal trends of cause-specific mortality after diagnosis of atrial fibrillation.European heart journal · 2023Article
- Atrial fibrillation and stroke prevention: 25 years of research at EP Europace journal.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Outcomes of patients with atrial fibrillation on oral anticoagulation with and without heart failure: the ETNA-AF-Europe registry.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Observational
- Use of Direct Acting Oral Anticoagulants in Elderly Patients with Atrial Fibrillation: A Multicenter, Cross-Sectional Study in Spain.Journal of clinical medicine · 2023Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
aimsPeople with atrial fibrillation (AF) frequently live with frailty, which increases the risk of mortality and stroke. This study reports the association between oral anticoagulation (OAC) and outcomes for people with frailty, and whether there is overall net benefit from treatment in people with AF. METHODS AND
resultsRetrospective open cohort electronic records study. Frailty was identified using the electronic frailty index. Primary care electronic health records of 89 996 adults with AF and CHA2DS2-Vasc score of ≥2 were linked with secondary care and mortality data in the Clinical Practice Research Database (CPRD) from 1 January 1998 to 30 November 2018. The primary outcome was a composite of death, stroke, systemic embolism, or major bleeding. Secondary outcomes were stroke, major bleeding, all-cause mortality, transient ischaemic attack, and falls. Of 89 996 participants, 71 256 (79.2%) were living with frailty. The prescription of OAC increased with degree of frailty. For patients not prescribed OAC, rates of the primary outcome increased alongside frailty category. Prescription of OAC was associated with a reduction in the primary outcome for each frailty category [adjusted hazard ratio, 95% confidence interval, no OAC as reference; fit: vitamin K antagonist (VKA) 0.69, 0.64-0.75, direct oral anticoagulant (DOAC) 0.42, 0.33-0.53; mild frailty: VKA 0.52, 0.50-0.54, DOAC 0.57, 0.52-0.63; moderate: VKA 0.54, 0.52-0.56, DOAC 0.57, 0.52-0.63; severe: VKA 0.48, 0.45-0.51, DOAC 0.58, 0.52-0.65], with cumulative incidence function effects greater for DOAC than VKA.
conclusionFrailty among people with AF is common. The OAC was associated with a reduction in the primary endpoint across all degrees of frailty.
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