[Risk of hemorrhage in patients older than 85 years, anticoagulated due to atrial fibrillation].
BACKGROUND
Atrial fibrillation is the most common cardiac tachyarrhythmia and is an important independent risk factor for ischemic stroke. Its prevalence begins to increase in both sexes after 40 years of age as well as the risk of hemorrhage. The aim of this study was to compare the annual rate of hemorrhagic events between patients older and younger than 85 years, with diagnosis of nonvalvular atrial fibrillation and anticoagulated with warfarin.


METHODS
A retrospective study was performed. We included 118 patients with diagnosis of nonvalvular atrial fibrillation monitorized by an informatized follow up system.


RESULTS
The study follow-up was 28,2 ± 17,5 months and 24 patients (20,3%) were older than 85 years of age. The rate of major bleedings was 4,62%/year (older than 85 years) vs 0,95%/year (younger than 85 years) , p= 0,05, OR 6,57 (IC 95% 1,04-41,8) and minor bleeding was 4,62%/year (older than 85 years) vs 5,2%/year (younger than 85 years), p=0,99, OR 1,08 (IC 95% 0,28-4,21). There was no difference in the Time in Therapeutic Range between both groups (56.4 ± 16.3 % vs 60.5 ± 17.7 %, p 0,30).


CONCLUSIONS
The age should not be considered a contraindication to anticoagulant therapy, however, special care and careful monitoring of patients older than 85 years should be considered due to they had high risk of bleeding.
Servicio de Clínica Médica1 y Cardiología2, Hospital Privado Centro Médico de Córdoba, Córdoba, Argentina.
Jose I
JI
Revigliono
Tomas
T
Amuchastegui
Alejandro E
AE
Contreras
Marcos
M
Amuchastegui
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
D000925:Anticoagulants