Comparison of the clinical features and outcomes in two age-groups of elderly patients with atrial fibrillation.

Abstract

BACKGROUND:

Atrial fibrillation (AF) disproportionately affects older adults. However, direct comparison of clinical features, medical therapy, and outcomes in AF patients aged 65-74 and ≥ 75 years is rare. The objective of the present study was to evaluate the differences in clinical characteristics and prognosis in these two age-groups of geriatric patients with AF.

MATERIALS AND METHODS:

A total of 1,336 individuals aged ≥ 65 years from a Chinese AF registry were assessed in the present study: 570 were in the 65- to 74-year group, and 766 were in the ≥ 75-year group. Multivariable Cox hazards regression was performed to analyze the major adverse cardiac events (MACEs) between groups.

RESULTS:

In our population, the older group were more likely to have coronary artery disease, hypertension, previous stroke, cognitive disorder, or chronic obstructive pulmonary disease, and the 65- to 74-year group were more likely to have valvular heart disease, left ventricular systolic dysfunction, or sleep apnea. The older patients had 1.2-fold higher mean CHADS2 (congestive heart failure, hypertension, age ≥ 75 years, diabetes, stroke) scores, but less probability of being prescribed drugs. Compared with those aged 65-74 years, the older group had a higher risk of death (hazard ratio 2.881, 95% confidence interval 1.981-4.189; P<0.001) or MACE (hazard ratio 2.202, 95% confidence interval 1.646-2.945; P<0.001) at the 1-year follow-up. In multivariable Cox analyses, secondary AF diagnosis, a history of chronic obstructive pulmonary disease, and left ventricular systolic dysfunction were independent predictors of MACE in the older group.

CONCLUSION:

Patients aged ≥ 75 years had a worse prognosis than those aged 65-74 years, and were associated with a higher risk of both death and MACE.

• Authors: Xing-Hui Shao, Yan-Min Yang, Jun Zhu, Han Zhang, Yao Liu, Xin Gao, Li-Tian Yu, Li-Sheng Liu, Li Zhao, Peng-Fei Yu, Hua Zhang, Qing He, Xiao-Dan Gu
• Journal: Clinical interventions in aging (Clin Interv Aging) Vol. 9 Pg. 1335-42 ( 2014) ISSN: 1178-1998 [Electronic] New Zealand
• PMID: 25143720 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Atrial Fibrillation (drug therapy, epidemiology)
• Cardiovascular Diseases (epidemiology)
• China (epidemiology)
• Female
• Geriatric Assessment
• Humans
• Male
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• Registries
• Risk Factors