Clinical features and risk factors of stroke/thromboembolism and bleeding in the elderly patients with atrial fibrillation
10.3760/cma.j.issn.0253-3758.2013.11.007
- VernacularTitle:老年心房颤动患者年龄相关的卒中/出血风险及临床特点
- Author:
Jin LI
1
;
Yu-Tao GUO
;
Chun-Jiang WANG
Author Information
1. 复旦大学附属华东医院老年病科
- Keywords:
Atrial fibrillation;
Cerebrovascular accident;
Haemorrhage;
Aged
- From:
Chinese Journal of Cardiology
2013;41(11):927-930
- CountryChina
- Language:Chinese
-
Abstract:
Objective The relationship between stroke/thromboembolic events (TEs) and bleeding as well as age-related risk factors are not fully clear in elderly patients with atrial fibrillation (AF).This study aimed to evaluate the clinical features,incidence and risk factors of stroke and bleeding in elderly AF patients.Method A total of 220 elderly AF patients [mean age (83.1 ± 0.6) years] were followed for (3.2 ± 0.8)years.The CHA2DS2-VASc score,the HAS-BLED score,annual major bleeding risk and the annual stroke were analyzed.Result The CHA2DS2-VASc score in patients with 65-79,80-89 and ≥90 years old groups were 2.9 ± 0.2,5.2 ± 0.2 and 5.6 ± 0.2,respectively (P ＜ 0.001) and the HASBLED score were 2.1 ±0.1,3.2 ±0.1 and 3.6 ±0.1,respectively (P ＜0.001),both significantly increased with aging.The annual major bleeding risk increased similarly as the annual stroke risk in the very elderly AF patients (patients 80-89 years old:bleeding risk 3.7 ％,stroke risk 6.7 ％ ; patients ≥ 90 years old:8.7 ％ and 9.8 ％,respectively).The combination of CHA2DS2-VASc and HAS-BLED could identify those patients with high risk for stroke and bleeding correctly.Twelve (5.5％) patients experienced "bidirectional events" (concomitant TE and haemorrhage),of whom 9 (75.0 ％) suffered recurrent TEs.Conclusion The bleeding risk increased similarly as the thromboembotic risk with increasing age in the elderly AF patients,"bidirectional events" is not common but related with worse outcome in elderly AF patients.
