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Embolic events in 93 elderly Chinese patients with atrial fibrillation
Insights
Embolic events are common in elderly Chinese patients with atrial fibrillation (AF). Anticoagulation therapy is recommended, particularly for those with identified risk factors for embolism.
Area of Science:
- Cardiology
- Geriatrics
- Pathology
Background:
- Atrial fibrillation (AF) is a common arrhythmia in the elderly.
- Embolic events are a significant complication of AF, leading to increased morbidity and mortality.
- Understanding the prevalence and risk factors for embolism in elderly Chinese AF patients is crucial for prevention.
Purpose of the Study:
- To determine the prevalence of embolic events in elderly Chinese patients diagnosed with atrial fibrillation.
- To identify clinical and pathological factors associated with embolic events in this population.
- To provide evidence-based recommendations for the prevention of embolic events in elderly AF patients.
Main Methods:
- Analysis of autopsy data from 93 elderly Chinese patients with atrial fibrillation.
- Examination of the incidence of embolic events in relation to underlying diseases, cardiac pathology, and clinical characteristics.
- Evaluation of the potential preventive effects of dipyridamole or aspirin.
Main Results:
- Embolic events were observed in 29.03% (27 out of 93) of cases.
- Higher incidence of embolism in patients with rheumatic heart disease compared to other heart conditions.
- Increased embolism risk associated with chronic AF (>3 years), heart failure, diabetes, left atrial/ventricular enlargement, mural thrombosis, valvular calcification, and vegetation.
- Oral dipyridamole or aspirin showed no definitive preventive effect on embolism.
Conclusions:
- Elderly Chinese patients with atrial fibrillation exhibit a high incidence of embolic events.
- Anticoagulation therapy is strongly recommended for elderly AF patients, especially those with risk factors for embolism.
- Current antiplatelet therapies (dipyridamole, aspirin) demonstrated limited efficacy in preventing embolism in this study population.
Objectives:
To evaluate the prevalence of embolic events and relevant factors in elderly Chinese patients with atrial fibrillation(AF), and to provide evidence on ways to prevent embolic events.
Methods:
Autopsy data from ninety-three continous elderly Chinese patients with AF were analysed. The incidence of embolic events and its relationship to underlying disease, pathologic changes in the heart, and other clinical characteristics were examined.
Results:
Embolism were observed in 27 of 93 cases, with an incidence of 29.03%. The incidence of embolic events was higher in elderly patients with rheumatic heart disease than those with coronary artery disease, hypertensive myocardiopathy and heart diseases. Patients with chronic AF, with a course of AF > or = 3 years, and those with heart failure or diabetes had a higher incidence of embolic events than those without these complications. There was significant difference in incidence between paroxysmal and chronic AF. Patients with left atrial or ventricular enlargement, mural thrombosis in cardiac chambers, valvular calcification and valvular vegetation also had a higher incidence of embolic events. Oral dipyridamole (75-150 mg/d) or aspirin (50-150 mg/d) showed no definite effects in preventing embolism in some patients.
Conclusions:
There was a high incidence of embolic events in elderly Chinese patients with AF. Anticoagulation therapy should be provided to the elderly patients with AF, especially to the patients with risk factors for embolism.