Survey of Atrial Fibrillation and Thromboembolism in the Elderly: A Multicenter Cooperative Study.
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Accession number;99A0217965
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| Title;Survey of Atrial Fibrillation and Thromboembolism in the Elderly: A Multicenter Cooperative Study. |
| Author;
SAKURAI MASAYUKI
(Hokkaido Univ.)
IKEDA KOZUE
(Yamagata Univ.)
KUGA KEISUKE
(Univ. of Tsukuba)
WATANABE ICHIRO
(Nihon Univ.)
NAKAZATO YUJI
(Juntendo Univ.)
SUZUKI FUMIO
(Tokyo Med. and Dent. Univ.)
MITAMURA HIDEO
(Keio Univ.)
INOUE HIROSHI
(Toyama Med. and Pharm. Univ.)
OKUMURA KEN
(Kumamoto Univ.)
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Journal Title;J Cardiol
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Journal Code:Y0264A
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ISSN:0914-5087
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VOL.33;NO.1;PAGE.27-35(1999)
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| Figure&Table&Reference;FIG.4, TBL.3, REF.32 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;A multicenter, retrospective study was undertaken to survey the prevalence of thromboembolism complicated with atrial fibrillation and the efficacy of treatment in both elderly and younger patients. The primary prevention group consisted of 1,810 patients without prior cerebral thromboembolism, and was divided into the elderly patient group(.GEQ.65 years old, 588 patients) and younger patient group(<65 years old, 1,222 patients). The elderly group had higher prevalences of chronic atrial fibrillation(65.3% vs 56.4%, p<0.001) and ischemic heart disease and hypertension(16.8% vs 9.3% and 34.2% vs 24.4%, respectively, p<0.001) and lower prevalence of treatment with warfarin(9.2% vs 20.1%, p<0.001). Elderly patients with mitral valve disease and hypertension had lower prevalence of treatment with warfarin as compared with younger patients(p<0.001). This was also true for the secondary prevention group of 147 patients with prior history of cerebral infarction(p<0.001). During the mean follow-up period of 4.6 years, patients with underlying cardiac diseases had a higher risk of thromboembolism compared with those without cardiac diseases for both the elderly(12.1% vs 6.1%, p<0.05) and younger(7.5% vs 3.6%, p<0.02) groups. Treatment with antiplatelets or warfarin could reduce the risk of thromboembolism in the elderly group(p<0.1) and the younger group(p<0.001). The risk of major hemorrhagic complication, i.e., gastrointestinal tract or intracranial hemorrhage, was quite low in patients receiving antithrombotic drugs. The present study indicates that the attitude toward the use of warfarin for prevention of thromboembolism is conservative and the risk of thromboembolism is higher in elderly patients with atrial fibrillation in Japan. Our attitude to the use of antithrombotic drugs in elderly patients with atrial fibrillation needs to be modified. (author abst.) |
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