Presence of Geriatric Conditions Is Prognostic of Major Bleeding in Older Patients with Atrial Fibrillation: a Cohort Study.
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
14
09
2021
accepted:
07
01
2022
pubmed:
2
2
2022
medline:
10
11
2022
entrez:
1
2
2022
Statut:
ppublish
Résumé
In older patients with atrial fibrillation (AF), physical, cognitive, and psychosocial limitations are prevalent. The prognostic value of these conditions for major bleeding is unclear. To determine whether geriatric conditions are prospectively associated with major bleeding in older patients with AF on anticoagulation. Multicenter cohort study with 2-year follow-up from 2016 to 2020 in Massachusetts and Georgia from cardiology, electrophysiology, and primary care clinics. Diagnosed with AF, age 65 years or older, CHA A six-component geriatric assessment of frailty, cognitive function, social support, depressive symptoms, vision, and hearing. Main outcome was major bleeding adjudicated by a physician panel. At baseline, participants were, on average, 75.5 years old and 49% were women. Mean CHA In older patients with AF taking anticoagulants, cognitive impairment and frailty were independently associated with major bleeding.
Sections du résumé
BACKGROUND
In older patients with atrial fibrillation (AF), physical, cognitive, and psychosocial limitations are prevalent. The prognostic value of these conditions for major bleeding is unclear.
OBJECTIVE
To determine whether geriatric conditions are prospectively associated with major bleeding in older patients with AF on anticoagulation.
DESIGN
Multicenter cohort study with 2-year follow-up from 2016 to 2020 in Massachusetts and Georgia from cardiology, electrophysiology, and primary care clinics.
PARTICIPANTS
Diagnosed with AF, age 65 years or older, CHA
MAIN MEASURES
A six-component geriatric assessment of frailty, cognitive function, social support, depressive symptoms, vision, and hearing. Main outcome was major bleeding adjudicated by a physician panel.
KEY RESULTS
At baseline, participants were, on average, 75.5 years old and 49% were women. Mean CHA
CONCLUSIONS
In older patients with AF taking anticoagulants, cognitive impairment and frailty were independently associated with major bleeding.
Identifiants
pubmed: 35102482
doi: 10.1007/s11606-022-07410-x
pii: 10.1007/s11606-022-07410-x
pmc: PMC9640487
doi:
Substances chimiques
Anticoagulants
0
Types de publication
Multicenter Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
3893-3899Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL126911
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL137734
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL141434
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01HL126911
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL137794
Pays : United States
Informations de copyright
© 2022. The Author(s) under exclusive licence to Society of General Internal Medicine.
Références
BMJ. 2018 Jul 4;362:k2505
pubmed: 29973392
Front Cardiovasc Med. 2019 Oct 30;6:155
pubmed: 31737647
Nat Rev Neurosci. 2007 Mar;8(3):233-9
pubmed: 17299455
Circ Res. 2020 Jun 19;127(1):4-20
pubmed: 32716709
Circulation. 2018 Jul 3;138(1):37-47
pubmed: 29490992
JAMA. 2001 May 9;285(18):2370-5
pubmed: 11343485
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Am Heart J. 2009 Jul;158(1):111-7
pubmed: 19540400
Ann Med. 2016;48(1-2):59-66
pubmed: 26758363
J Am Geriatr Soc. 2008 Dec;56(12):2211-16
pubmed: 19093920
Chest. 2010 Nov;138(5):1093-100
pubmed: 20299623
Heart Rhythm. 2018 Apr;15(4):487-493
pubmed: 29475795
Circulation. 2009 Jul 14;120(2):134-40, 3p following 140
pubmed: 19564557
J Am Geriatr Soc. 2020 Jan;68(1):147-154
pubmed: 31574165
N Engl J Med. 2011 Sep 15;365(11):981-92
pubmed: 21870978
Clin Geriatr Med. 2011 Feb;27(1):1-15
pubmed: 21093718
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
J Am Geriatr Soc. 2005 Apr;53(4):695-9
pubmed: 15817019
J Am Heart Assoc. 2018 Apr 14;7(8):
pubmed: 29656278
Ann Intern Med. 2014 Jan 21;160(2):122-31
pubmed: 24592497
Soc Sci Med. 1991;32(6):705-14
pubmed: 2035047
Am J Cardiol. 2020 May 1;125(9):1317-1323
pubmed: 32147090
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Chest. 2010 Feb;137(2):263-72
pubmed: 19762550
N Engl J Med. 2011 Sep 8;365(10):883-91
pubmed: 21830957
Am Heart J. 2019 May;211:77-89
pubmed: 30901602
J Thromb Haemost. 2005 Apr;3(4):692-4
pubmed: 15842354
J Cardiovasc Electrophysiol. 2019 Nov;30(11):2508-2515
pubmed: 31515920