MedStar Authors catalog › Details for: Association between Lifetime Risk of Atrial Fibrillation and Mortality in the Oldest Old.
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Association between Lifetime Risk of Atrial Fibrillation and Mortality in the Oldest Old.

by Shara, Nawar M.
Citation: ; Clinical Cardiology. 41(5):634-639, 2018 May..Journal: Clinical cardiology.Published: 2018ISSN: 0160-9289.Full author list: Kheirbek RE; Fokar A; Moore HJ; Shara N; Doukky R; Fletcher RD.UI/PMID: 29566272.Subject(s): Age Factors | Aged | Aged, 80 and over | *Aging | Anticoagulants/tu [Therapeutic Use] | Atrial Fibrillation/di [Diagnosis] | Atrial Fibrillation/dt [Drug Therapy] | *Atrial Fibrillation/mo [Mortality] | Atrial Fibrillation/pp [Physiopathology] | Female | Humans | Incidence | Kaplan-Meier Estimate | Longitudinal Studies | Male | Platelet Aggregation Inhibitors/tu [Therapeutic Use] | Prognosis | Proportional Hazards Models | Protective Factors | Retrospective Studies | Risk Factors | Time Factors | United States/ep [Epidemiology] | United States Department of Veterans Affairs | Veterans HealthInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) ORCID: Kheirbek, Raya Elfadel (Click here) Abbreviated citation: ; Clin Cardiol. 41(5):634-639, 2018 May.Local Holdings: Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: Age is the strongest predictor of atrial fibrillation (AF), yet little is known about AF incidence in the oldest old.Abstract: HYPOTHESIS: AF incidence declines after age 90, and morbidity is compressed into a brief period at the end of life.Abstract: METHODS: In this retrospective, longitudinal cohort study of patients (born 1905-1935), we examined cumulative lifetime incidence of AF and its impact on mortality. Data included records from 1,062,610 octogenarians; 317,161 nonagenarians; and 3,572 centenarians. Kaplan-Meier curves were used to estimate cumulative incidence of AF by age group, incidence rates were compared using log-rank tests, and Cox proportional-hazards model were used to estimate unadjusted hazard ratios. The primary outcome was AF incidence at > age 80; the secondary outcome was mortality.Abstract: RESULTS: Cumulative AF incidence rate was 5.0% in octogenarians, 5.4% in nonagenarians, and 2.3% in centenarians. Octogenarians and nonagenarians had a higher risk of AF incidence compared to centenarians (adjusted hazard ratio 8.74; 95% CI [6.31-12.04] and 2.98; 95%CI [2.17-4.1], respectively). The lowest hazard ratio for mortality in patients with AF compared to those without 2.3; 95% CI(2.3-2.4) in patients who are on antiplatelet and anticoagulant medication, and have a score of 0 on the Elixhauser comorbidity index score.Abstract: CONCLUSION: Although AF incidence increased with age, being a centenarian was associated with reduced incidence and compression of morbidity. Patients with AF had a higher adjusted mortality rate. However, data suggests that a regimen of anticoagulant and antiplatelet seems to reduce risk of mortality in patients with AF diagnosis.Abstract: Copyright This article is protected by copyright. All rights reserved.

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