Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan ― Insight From the ANAFIE (All Nippon AF In Elderly) Registry
Background:Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical cha...
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| Veröffentlicht in: | Circulation Journal 2020/02/25, Vol.84(3), pp.388-396 |
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| creator | Hiasa, Ken-ichi Kaku, Hidetaka Inoue, Hiroshi Yamashita, Takeshi Akao, Masaharu Atarashi, Hirotsugu Koretsune, Yukihiro Okumura, Ken Shimizu, Wataru Ikeda, Takanori Toyoda, Kazunori Hirayama, Atsushi Yasaka, Masahiro Yamaguchi, Takenori Teramukai, Satoshi Kimura, Tetsuya Kaburagi, Jumpei Takita, Atsushi Tsutsui, Hiroyuki |
| description | Background:Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE Registry is a multicenter, prospective, observational registry of 32,726 non-valvular AF patients aged ≥75 years. The present study assessed the age-related differences in baseline clinical status and anticoagulant therapy between age groups 75– |
| doi_str_mv | 10.1253/circj.CJ-19-0898 |
| format | Article |
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Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE Registry is a multicenter, prospective, observational registry of 32,726 non-valvular AF patients aged ≥75 years. The present study assessed the age-related differences in baseline clinical status and anticoagulant therapy between age groups 75–<80, 80–<85, 85–<90, and ≥90 years. The prevalence of persistent or permanent AF increased, and that of paroxysmal AF decreased, with increasing age (trend P<0.0001). The risk of stroke, based on CHADS2and CHA2DS2-VASc scores, and bleeding, based on HAS-BLED score, increased with age. Both warfarin and apixaban were used more often as age increased (trend P<0.0001, for each), while other anticoagulants were used less. Anticoagulant doses were significantly lower in older patients.Conclusions:Permanent/persistent AF, comorbidities, and cardiovascular and bleeding risk all increased significantly with age. Furthermore, use of warfarin and apixaban increased with age, accompanied by a decrease in other oral anticoagulant usage.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-19-0898</identifier><identifier>PMID: 31969518</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject><![CDATA[Administration, Oral ; Age Factors ; Aged ; Aged, 80 and over ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Anticoagulation ; Atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - epidemiology ; Comorbidity ; Elderly ; Factor Xa Inhibitors - administration & dosage ; Factor Xa Inhibitors - adverse effects ; Female ; Healthcare Disparities ; Hemorrhage - chemically induced ; Humans ; Japan - epidemiology ; Male ; Prevalence ; Prospective Studies ; Pyrazoles - administration & dosage ; Pyrazoles - adverse effects ; Pyridones - administration & dosage ; Pyridones - adverse effects ; Registries ; Risk Assessment ; Risk Factors ; Stroke - diagnosis ; Stroke - epidemiology ; Stroke - prevention & control ; Stroke prophylaxis ; Time Factors ; Treatment Outcome ; Warfarin - administration & dosage ; Warfarin - adverse effects]]></subject><ispartof>Circulation Journal, 2020/02/25, Vol.84(3), pp.388-396</ispartof><rights>2020 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-1f053b8159697d13639da24d5d330a6a4b9d014061566451e27059f145ba2ece3</citedby><cites>FETCH-LOGICAL-c494t-1f053b8159697d13639da24d5d330a6a4b9d014061566451e27059f145ba2ece3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1881,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31969518$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hiasa, Ken-ichi</creatorcontrib><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Inoue, Hiroshi</creatorcontrib><creatorcontrib>Yamashita, Takeshi</creatorcontrib><creatorcontrib>Akao, Masaharu</creatorcontrib><creatorcontrib>Atarashi, Hirotsugu</creatorcontrib><creatorcontrib>Koretsune, Yukihiro</creatorcontrib><creatorcontrib>Okumura, Ken</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Ikeda, Takanori</creatorcontrib><creatorcontrib>Toyoda, Kazunori</creatorcontrib><creatorcontrib>Hirayama, Atsushi</creatorcontrib><creatorcontrib>Yasaka, Masahiro</creatorcontrib><creatorcontrib>Yamaguchi, Takenori</creatorcontrib><creatorcontrib>Teramukai, Satoshi</creatorcontrib><creatorcontrib>Kimura, Tetsuya</creatorcontrib><creatorcontrib>Kaburagi, Jumpei</creatorcontrib><creatorcontrib>Takita, Atsushi</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><title>Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan ― Insight From the ANAFIE (All Nippon AF In Elderly) Registry</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE Registry is a multicenter, prospective, observational registry of 32,726 non-valvular AF patients aged ≥75 years. The present study assessed the age-related differences in baseline clinical status and anticoagulant therapy between age groups 75–<80, 80–<85, 85–<90, and ≥90 years. The prevalence of persistent or permanent AF increased, and that of paroxysmal AF decreased, with increasing age (trend P<0.0001). The risk of stroke, based on CHADS2and CHA2DS2-VASc scores, and bleeding, based on HAS-BLED score, increased with age. Both warfarin and apixaban were used more often as age increased (trend P<0.0001, for each), while other anticoagulants were used less. Anticoagulant doses were significantly lower in older patients.Conclusions:Permanent/persistent AF, comorbidities, and cardiovascular and bleeding risk all increased significantly with age. Furthermore, use of warfarin and apixaban increased with age, accompanied by a decrease in other oral anticoagulant usage.</description><subject>Administration, Oral</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulation</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Comorbidity</subject><subject>Elderly</subject><subject>Factor Xa Inhibitors - administration & dosage</subject><subject>Factor Xa Inhibitors - adverse effects</subject><subject>Female</subject><subject>Healthcare Disparities</subject><subject>Hemorrhage - chemically induced</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Pyrazoles - administration & dosage</subject><subject>Pyrazoles - adverse effects</subject><subject>Pyridones - administration & dosage</subject><subject>Pyridones - adverse effects</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>Stroke - prevention & control</subject><subject>Stroke prophylaxis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Warfarin - administration & dosage</subject><subject>Warfarin - adverse effects</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1u1DAUhSMEoqWwZ4W8LIsU_yUTL6MwgRlVBVVFLC3HuZnxKHGC7VnMbl6Cx-Fl4EXw_LTd2Jb1nXN8fZLkPcE3hGbskzZOb26qZUpEigtRvEguCeOzlBcUvzye81QUnF0kb7zfYEwFzsTr5IIRkYuMFJfJn3IF6T30KkCLPpuuAwdWg0fGorAGVPXGGq16VK2VUzqAMz4Y7ZGyLXpwoMIANqCxQ_O-Bdfv0HcVTLzy6KcJa1QGZ6K6No0zfUwxoz1YL9Wk7L_9_u_-N1pYb1brgGo3DsfM8q6sF3N0XfY9ujPTFCVlHbHHiI_oHlbxGW73NnnVqd7Du_N-lfyo5w_V1_T225dFVd6mmgseUtLhjDUFyeLUs5awnIlWUd5mLWNY5Yo3osWE45xkec4zAnQW_6kjPGsUBQ3sKrk--U5u_LUFH-RgvIY4kIVx6yVlnFOak5xGFJ9Q7UbvHXRycmZQbicJlofS5LE0WS0lEfJQWpR8OLtvmwHaJ8FjSxGoT8DGB7WCJ0C5WEUPZ8eCS3ZYnp2fgVieBMv-A4durwE</recordid><startdate>20200225</startdate><enddate>20200225</enddate><creator>Hiasa, Ken-ichi</creator><creator>Kaku, Hidetaka</creator><creator>Inoue, Hiroshi</creator><creator>Yamashita, Takeshi</creator><creator>Akao, Masaharu</creator><creator>Atarashi, Hirotsugu</creator><creator>Koretsune, Yukihiro</creator><creator>Okumura, Ken</creator><creator>Shimizu, Wataru</creator><creator>Ikeda, Takanori</creator><creator>Toyoda, Kazunori</creator><creator>Hirayama, Atsushi</creator><creator>Yasaka, Masahiro</creator><creator>Yamaguchi, Takenori</creator><creator>Teramukai, Satoshi</creator><creator>Kimura, Tetsuya</creator><creator>Kaburagi, Jumpei</creator><creator>Takita, Atsushi</creator><creator>Tsutsui, Hiroyuki</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200225</creationdate><title>Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan ― Insight From the ANAFIE (All Nippon AF In Elderly) Registry</title><author>Hiasa, Ken-ichi ; Kaku, Hidetaka ; Inoue, Hiroshi ; Yamashita, Takeshi ; Akao, Masaharu ; Atarashi, Hirotsugu ; Koretsune, Yukihiro ; Okumura, Ken ; Shimizu, Wataru ; Ikeda, Takanori ; Toyoda, Kazunori ; Hirayama, Atsushi ; Yasaka, Masahiro ; Yamaguchi, Takenori ; Teramukai, Satoshi ; Kimura, Tetsuya ; Kaburagi, Jumpei ; Takita, Atsushi ; Tsutsui, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-1f053b8159697d13639da24d5d330a6a4b9d014061566451e27059f145ba2ece3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Administration, Oral</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Anticoagulation</topic><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Comorbidity</topic><topic>Elderly</topic><topic>Factor Xa Inhibitors - administration & dosage</topic><topic>Factor Xa Inhibitors - adverse effects</topic><topic>Female</topic><topic>Healthcare Disparities</topic><topic>Hemorrhage - chemically induced</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Pyrazoles - administration & dosage</topic><topic>Pyrazoles - adverse effects</topic><topic>Pyridones - administration & dosage</topic><topic>Pyridones - adverse effects</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>Stroke - prevention & control</topic><topic>Stroke prophylaxis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Warfarin - administration & dosage</topic><topic>Warfarin - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hiasa, Ken-ichi</creatorcontrib><creatorcontrib>Kaku, Hidetaka</creatorcontrib><creatorcontrib>Inoue, Hiroshi</creatorcontrib><creatorcontrib>Yamashita, Takeshi</creatorcontrib><creatorcontrib>Akao, Masaharu</creatorcontrib><creatorcontrib>Atarashi, Hirotsugu</creatorcontrib><creatorcontrib>Koretsune, Yukihiro</creatorcontrib><creatorcontrib>Okumura, Ken</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Ikeda, Takanori</creatorcontrib><creatorcontrib>Toyoda, Kazunori</creatorcontrib><creatorcontrib>Hirayama, Atsushi</creatorcontrib><creatorcontrib>Yasaka, Masahiro</creatorcontrib><creatorcontrib>Yamaguchi, Takenori</creatorcontrib><creatorcontrib>Teramukai, Satoshi</creatorcontrib><creatorcontrib>Kimura, Tetsuya</creatorcontrib><creatorcontrib>Kaburagi, Jumpei</creatorcontrib><creatorcontrib>Takita, Atsushi</creatorcontrib><creatorcontrib>Tsutsui, Hiroyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hiasa, Ken-ichi</au><au>Kaku, Hidetaka</au><au>Inoue, Hiroshi</au><au>Yamashita, Takeshi</au><au>Akao, Masaharu</au><au>Atarashi, Hirotsugu</au><au>Koretsune, Yukihiro</au><au>Okumura, Ken</au><au>Shimizu, Wataru</au><au>Ikeda, Takanori</au><au>Toyoda, Kazunori</au><au>Hirayama, Atsushi</au><au>Yasaka, Masahiro</au><au>Yamaguchi, Takenori</au><au>Teramukai, Satoshi</au><au>Kimura, Tetsuya</au><au>Kaburagi, Jumpei</au><au>Takita, Atsushi</au><au>Tsutsui, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan ― Insight From the ANAFIE (All Nippon AF In Elderly) Registry</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2020-02-25</date><risdate>2020</risdate><volume>84</volume><issue>3</issue><spage>388</spage><epage>396</epage><pages>388-396</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE Registry is a multicenter, prospective, observational registry of 32,726 non-valvular AF patients aged ≥75 years. The present study assessed the age-related differences in baseline clinical status and anticoagulant therapy between age groups 75–<80, 80–<85, 85–<90, and ≥90 years. The prevalence of persistent or permanent AF increased, and that of paroxysmal AF decreased, with increasing age (trend P<0.0001). The risk of stroke, based on CHADS2and CHA2DS2-VASc scores, and bleeding, based on HAS-BLED score, increased with age. Both warfarin and apixaban were used more often as age increased (trend P<0.0001, for each), while other anticoagulants were used less. Anticoagulant doses were significantly lower in older patients.Conclusions:Permanent/persistent AF, comorbidities, and cardiovascular and bleeding risk all increased significantly with age. Furthermore, use of warfarin and apixaban increased with age, accompanied by a decrease in other oral anticoagulant usage.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>31969518</pmid><doi>10.1253/circj.CJ-19-0898</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1346-9843 |
| ispartof | Circulation Journal, 2020/02/25, Vol.84(3), pp.388-396 |
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| subjects | Administration, Oral Age Factors Aged Aged, 80 and over Anticoagulants - administration & dosage Anticoagulants - adverse effects Anticoagulation Atrial fibrillation Atrial Fibrillation - diagnosis Atrial Fibrillation - drug therapy Atrial Fibrillation - epidemiology Comorbidity Elderly Factor Xa Inhibitors - administration & dosage Factor Xa Inhibitors - adverse effects Female Healthcare Disparities Hemorrhage - chemically induced Humans Japan - epidemiology Male Prevalence Prospective Studies Pyrazoles - administration & dosage Pyrazoles - adverse effects Pyridones - administration & dosage Pyridones - adverse effects Registries Risk Assessment Risk Factors Stroke - diagnosis Stroke - epidemiology Stroke - prevention & control Stroke prophylaxis Time Factors Treatment Outcome Warfarin - administration & dosage Warfarin - adverse effects |
| title | Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan ― Insight From the ANAFIE (All Nippon AF In Elderly) Registry |
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