Association between Lifetime Risk of Atrial Fibrillation and Mortality in the Oldest Old. 

 -  2018 
<br/><br/>Available online from MWHC library: 1976 - present, Available in print through MWHC library:1999-2007 
<br/><br/> BACKGROUND: Age is the strongest predictor of atrial fibrillation (AF), yet little is known about AF incidence in the oldest old.  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.  Copyright This article is protected by copyright. All rights reserved.  HYPOTHESIS: AF incidence declines after age 90, and morbidity is compressed into a brief period at the end of life.  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.  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. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0160-9289 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Aging<br/>*Atrial Fibrillation/mo [Mortality]<br/>Age Factors<br/>Aged<br/>Aged, 80 and over<br/>Anticoagulants/tu [Therapeutic Use]<br/>Atrial Fibrillation/di [Diagnosis]<br/>Atrial Fibrillation/dt [Drug Therapy]<br/>Atrial Fibrillation/pp [Physiopathology]<br/>Female<br/>Humans<br/>Incidence<br/>Kaplan-Meier Estimate<br/>Longitudinal Studies<br/>Male<br/>Platelet Aggregation Inhibitors/tu [Therapeutic Use]<br/>Prognosis<br/>Proportional Hazards Models<br/>Protective Factors<br/>Retrospective Studies<br/>Risk Factors<br/>Time Factors<br/>United States Department of Veterans Affairs<br/>United States/ep [Epidemiology]<br/>Veterans Health
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Health Research Institute
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article