Older patients with AF at higher stroke risk without anticoagulants, say researchers

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By Olivia Bowthorpe

Older patients with atrial fibrillation could be at risk of stroke, heart attack or death if not taking anticoagulation therapy, figures suggest.

Researchers have found that for patients aged 75 years or older, the rate of stroke was just over 3-fold higher among those not taking anticoagulation therapy.¹

The rate of heart attack was increased by 85%, and the rate of death was nearly 3-fold higher than for those on anticoagulation therapy.

"Clinicians should carefully weigh the risks of discontinuing anticoagulation and provide shared decision-making support to patients, especially when considering deprescription," state the researchers in the journal Heart.

Dr Anneka Mitchell, research training fellow at the University of Bath, and colleagues analysed UK primary care data on 20,167 elderly patients in the Clinical Practice Research Datalink, from 2013 to 2017. Exposure to anticoagulants (warfarin or direct oral anticoagulants) was taken from prescription data.

The researchers found that the anticoagulant apixaban was linked to a 27% lower risk of non-major bleeding compared with warfarin.