ArticleAge and ageing2025
Long-term clinical outcomes of oral anticoagulation in the older patients with atrial fibrillation aged ≥80 years: a report from the GLORIA-AF registry phase III.
Article in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- [Prognostic analysis of anticoagulation therapy in elderly patients with cardioembolic stroke].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
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11 authors.
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Abstract
backgroundOlder age increases the risk of thromboembolism (TE) and major bleeding in atrial fibrillation (AF) patients, but limited evidence exists regarding the older population (age ≥ 80) especially from different global regions. Data on benefits of oral anticoagulants in these very old individuals are also limited.
methodsFrom the prospective, multicenter Global Registry on Long-Term Antithrombotic Treatment in Patients with Atrial Fibrillation registry, we analysed by age all-cause death, cardiovascular death, major adverse cardiovascular events (MACE), TE, major bleeding, stroke, and myocardial infarction (MI) over 3-years follow-up.
resultsOf 7652 patients aged ≥75 years (age 80.1 ± 3.9 years, 47.1% male), 4006 were ≥ 80 years (age 83.4 ± 3.9 years, 43.5% male). After multivariable adjustment, older patients had a higher risk of all-cause death (HR:1.94, 95% CI: 1.67-2.27), cardiovascular death (HR: 2.17, 95% CI: 1.71-2.74), MACE (HR: 1.57, 95% CI: 1.32-1.86), TE (HR: 1.45, 95% CI: 1.14-1.83), major bleeding (HR: 1.30, 95% CI: 1.04-1.63), stroke (HR: 1.38, 95% CI: 1.06-1.80) and MI (HR: 1.59, 95% CI:1.14-2.22). Compared with VKA, NOAC use in patients ≥80 years was associated with lower risks of all-cause death (HR: 0.79, 95% CI: 0.65-0.97), cardiovascular death (HR: 0.70, 95% CI: 0.51-0.96), MACE (HR: 0.72, 95% CI: 0.56-0.92), and major bleeding (HR: 0.66, 95% CI: 0.48-0.92). NOACs were more beneficial than warfarin for mortality, MACE and major bleeding in frail patients. The risk of clinical events associated with older patients was primarily seen in Europe and Asia (p-interaction > 0.05), but the effectiveness and safety of NOACs vs. warfarin was consistent across regions.
conclusionsOlder age was independently associated with higher risk of death, major bleeding, TE and MACE. Compared with VKA, NOACs show improved effectiveness and safety in the older and patients with frailty, with similar efficacy across regions and ethnic groups.
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