Frailty and Anticoagulant Therapy in Patients Aged 65 Years or Older with Atrial Fibrillation  

作　　者：Jiapeng Liu Xin Du Mengmeng Li Zhaoxu Jia Shangxin Lu Sanshuai Chang Ribo Tang Rong Bai Jianzeng Dong Gregory Y.H.Lip Changsheng Ma 

机构地区：[1]Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University and National Clinical Research Center for Cardiovascular Diseases,Beijing,China [2]Heart Health Research Center,Beijing,China [3]University of New South Wales,Sydney,Australia [4]Department of Cardiology,The First Affi liated Hospital of Zhengzhou University,Zhengzhou,China [5]Liverpool Centre for Cardiovascular Science,University of Liverpool and Liverpool Heart and Chest Hospital,Liverpool,UK [6]Aalborg Thrombosis Research Unit,Department of Clinical Medicine,Aalborg University,Aalborg,Denmark

出　　处：《Cardiovascular Innovations and Applications》2020年第1期153-161,共9页心血管创新与应用（英文）

基　　金：This work was supported by the National Key Research and Development Program of China(2016YFC0900901,2016YFC1301002,2017YFC0908803,2018YFC1312501);a grant from the National Natural Science Foundation of China(81530016).

摘　　要：Background:Elderly adults with atrial fi brillation(AF)are at increased risk of frailty and thromboembolic complications.However,studies on the prevalence of frailty in AF patients and data on the relationship between frailty and the use of anticoagulants are limited.Methods:We conducted a cross-sectional study involving 500 participants.Patients aged 65 years or older were consecutively selected from the Chinese Atrial Fibrillation Registry study.The patient’s frailty status was assessed with use of the Canadian Study of Health and Aging Clinical Frailty Scale.We assessed the prevalence of and factors associated with frailty,and how frailty affects anticoagulant therapy.Results:In 500 elderly adults with AF(age 75.2±6.7 years;51.6%female),201 patients(40.2%)were frail.The prevalence of frailty was higher in females(P=0.002)and increased with age and CHA 2 DS 2-VASc score(P for trend less than 0.001 for both).The factors associated with frailty were a history of heart failure(odds ratio[OR]2.40,95%confi dence interval[CI]1.39–4.14),female sex(OR 2.09,95%CI 1.27–3.43),and advanced age(OR 1.13,95%CI 1.09–1.17).Frail patients were signifi cantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients(81.7 vs.54.9%,P<0.001).Conclusions:Frailty is prevalent in elderly adults with AF,especially in females,those of advanced age,and those with heart failure.Frailty status has a signifi cant impact on prescription of anticoagulants for high-risk AF patients.

关 键 词：ATRIAL fi brillation FRAILTY ANTICOAGULANT elderly ADULTS 

分 类 号：R54[医药卫生—心血管疾病]