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Clinical Outcomes of Oral Anticoagulation in Elderly East Asian Patients with Atrial Fibrillation: A Retrospective

Kyunyeon Kim1,2, YouMi Hwang1,2, Sang-Suk Choi1,2

  • 1Department of Cardiology, St. Vincent's Hospital, The Catholic University of Korea, Seoul 16247, Republic of Korea.

Life (Basel, Switzerland)
|August 28, 2025
PubMed

Insights

Direct oral anticoagulants (DOACs) are safe and effective for elderly East Asian patients with atrial fibrillation (AF), regardless of age. Clinical factors, not age alone, should guide treatment decisions for anticoagulation.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia, posing risks in the elderly.
  • Managing AF in very elderly patients presents challenges due to bleeding and thromboembolic risks.
  • East Asian elderly patients with non-valvular AF require specific outcome evaluations.

Purpose of the Study:

  • To evaluate clinical outcomes in elderly East Asian patients with non-valvular AF on oral anticoagulants.
  • To compare outcomes between age groups (70-79 and ≥80 years) receiving anticoagulation.
  • To assess the safety and efficacy of direct oral anticoagulants (DOACs) versus warfarin in different age strata.

Main Methods:

  • Retrospective single-center study of 502 patients aged ≥70 years.
  • Patients treated with direct oral anticoagulants (DOACs) or warfarin.
  • Stratification into two age groups: 70-79 years and ≥80 years.

Main Results:

  • Patients aged ≥80 years had numerically higher bleeding rates, but not statistically significant after adjustment.
  • Ischemic and thromboembolic event rates were comparable between age groups.
  • DOACs and warfarin showed similar safety and efficacy profiles across age groups when adjusted.

Conclusions:

  • Direct oral anticoagulants (DOACs) are safe and effective in very elderly East Asian patients with AF.
  • Individualized treatment decisions based on clinical factors are recommended over age alone.
  • Appropriate management ensures favorable outcomes for elderly AF patients on anticoagulation.

Keywords:
atrial fibrillationelderly patientsoral anticoagulants

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