Prognostic value of geriatric conditions for death and bleeding in older patients with atrial fibrillation
Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Authors
Wang, WeijiaLessard, Darleen M.
Saczynski, Jane S.
Goldberg, Robert J.
Mehawej, Jordy
Gracia, Ely
McManus, David D.
UMass Chan Affiliations
Department of Population and Quantitative Health SciencesDivision of Cardiovascular Medicine, Department of Medicine
Document Type
Journal ArticlePublication Date
2021-03-04Keywords
Atrial fibrillationBleeding
Depression
Frailty
Social isolation
Cardiology
Cardiovascular Diseases
Geriatrics
Psychiatry and Psychology
Metadata
Show full item recordAbstract
Background: Geriatric conditions, such as frailty and cognitive impairment, are prevalent in older patients with atrial fibrillation (AF). We examined the prognostic value of geriatric conditions for predicting 1-year mortality and bleeding events in these patients. Methods: SAGE (Systematic Assessment of Geriatric Elements)-AF study is a multicenter cohort study which enrolled individuals (mean age 75 years, 48% women, 86% taking oral anticoagulation) 65 years and older with AF and CHA2DS2 -VASc score of 2 or higher from clinics in Massachusetts and Georgia, USA between 2016 and 2018. A six-component geriatric assessment included validated measures of frailty, cognitive function, social support, depressive symptoms, vision, and hearing was performed at baseline. Study endpoints included all-cause mortality and clinically relevant bleeding. Results: At 1 year, 1,097 (96.5%) individuals attended the follow up visit, 44 (3.9%) had died, and 56 (5.1%) had clinically relevant bleeding. After adjustment for demographic and clinical factors, social isolation (odds ratio [OR] 1.69, 95% confidence interval [CI]: 1.01-2.84), depression (OR 1.94, 95% CI: 1.28-2.95) and frailty (OR 2.55, 95% CI: 1.55-4.19) were significantly associated with the composite endpoint of death or clinically relevant bleeding. After multivariable adjustment, depression (OR 1.79, 95% CI 1.09-2.93) and frailty (OR 2.83, 95% CI 1.55-5.17) were significantly associated with clinically relevant bleeding. Conclusions: Social isolation, depression, and frailty were prognostic of dying or experiencing clinically relevant bleeding during the coming year in older men and women with AF. Assessing geriatric impairments merits consideration in the care of these patients.Source
Wang W, Lessard D, Saczynski JS, Goldberg RJ, Mehawej J, Gracia E, McManus DD. Prognostic value of geriatric conditions for death and bleeding in older patients with atrial fibrillation. Int J Cardiol Heart Vasc. 2021 Mar 4;33:100739. doi: 10.1016/j.ijcha.2021.100739. PMID: 33728372; PMCID: PMC7935705. Link to article on publisher's site
DOI
10.1016/j.ijcha.2021.100739Permanent Link to this Item
http://hdl.handle.net/20.500.14038/29751PubMed ID
33728372Related Resources
Rights
Copyright 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Distribution License
http://creativecommons.org/licenses/by-nc-nd/4.0/ae974a485f413a2113503eed53cd6c53
10.1016/j.ijcha.2021.100739
Scopus Count
Except where otherwise noted, this item's license is described as Copyright 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).