Characteristics of non-valvular atrial fibrillation patients who benefit most from anticoagulation treatment

Yun-Li Xing, Qing Ma, Xiao-Ying Ma, Cui-Ying Wang, Zhen Zhou, Ying-Shuo Huang, Ying Sun
International Journal of Clinical and Experimental Medicine 2015, 8 (10): 18721-8

OBJECTIVES: The objective was to determine who will benefit most from oral anticoagulation (OAC) for non-valvular atrial fibrillation (NVAF) patients aged ≥ 75 years.

BACKGROUND: It was unclear whether all of NVAF aged ≥ 75 should receive OAC.

METHODS: We recruited NVAF ≥ 75 years without QAC who were divided into three groups according to CHA2DS-VASc scores. The clinical endpoints were ischemic stroke (IS), thromboembolism (TE), or death.

RESULTS: The patients with CHA2DS2-VASc score of 6-9 were not appropriate for anticoagulation with the highest HAS-BLED scores. CHA2DS2-VASc of 2 had little risk for IS/TE. We further divided CHA2DS2-VASc of 3-5 into three subgroups with estimated glomerular filtration rate (eGFR; ml/min/1.73 m(2)): < 30, 30-60, and > 60. The patients with eGFR < 30 had the highest bleeding risk with a comparable IS/TE.

CONCLUSIONS: NVAF with CHA2DS2-VASc of 3-5 and eGFR > 30 ml/min/1.73 m(2) represent the most appropriate population for anticoagulation.

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