Abstract 13355: The Characteristics and Outcomes of the Elderly Atrial Fibrillation Patients With or Without Oral Anticoagulants in Japanese Clinical Practice: The Fushimi AF Registry.

Introduction: Atrial fibrillation (AF) increases the risk of thromboembolism, and oral anticoagulants (OAC) are highly effective in preventing it. However, the risk of bleeding is also high in the elderly, especially in those with renal dysfunction. A recent large-scale population-based cohort study demonstrated the paradoxical increase of thromboembolism in elderly patients with renal dysfunction. Methods: The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Follow-up data were available in 4,325 patients, and 2,201 elderly patients (≥75 years) were examined. Those included 1,011 patients with chronic kidney disease (CKD) (estimate glomerular filtration rate(eGFR)<60) and 1,189 patients without CKD. We compared the clinical background and outcomes between patients with and without OAC. Results: In both groups, patients with OAC had tendency to have higher CHA2DS2-VASc score and lower HAS-BLED score, compared to those without OAC. The prevalence of heart failure (HF), stroke/systemic embolism (SE), and hypertension (HTN), and male gender were independently associated with OAC use, and high HAS-BLED score (≥3), severe CKD (eGFR<30) and advanced age ≥85 were associated with the absence of OAC in multivariable logistic regression analyses. During the median follow-up of 1,450 days, all-cause mortality was lower in patients with OAC in both groups, and ischemic stroke/SE and MB were similar between the two groups irrespective of the presence of CKD. Conclusions: In elderly Japanese AF patients, OAC use was not associated with the incidence of ischemic stroke/SE or MB, irrespective of the presence of CKD. [ABSTRACT FROM AUTHOR]