Open AccessImpact of age on thromboembolic events in patients with non‐valvular atrial fibrillation
Author(s) -
Kim Yun Gi,
Choi JongIl,
Boo Ki Yung,
Kim Do Young,
Hong Yeji,
Kim Min Sun,
Lee KwangNo,
Shim Jaemin,
Kim Jin Seok,
Kim YoungHoon
Publication year - 2020
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23293
Subject(s) - medicine , atrial fibrillation , cardiology , risk factor , odds ratio , hemodynamics
Background Age is a well‐established risk factor for thromboembolic events in patients with atrial fibrillation (AF). However, the mechanism underlying the association between age and thromboembolic events in AF remains unknown. Methods The prognostic value of age as a risk factor for thromboembolic events was analyzed using data from the Korean National Health Insurance Service (NHIS). In a large‐scale single‐center registry, cardiac hemodynamic parameters were examined to elucidate the cause of increased risk of thromboembolic events in older patients. Results NHIS sample cohort data including 5896 patients with AF revealed that the risk of thromboembolic complication differed significantly according to age despite equal CHA 2 DS 2 ‐VASc score. In the registry of 2801 patients, age showed significant correlations with left atrium (LA) diameter, LA volume, E/e′, pulmonary artery pressure, and LA appendage flow velocity. Older patients had a significantly higher prevalence of spontaneous echocontrast (odds ratio [OR] = 1.030; P < .001). Age (OR = 1.031; P < .001), E/e′ (OR = 1.065; P = .004), and LA appendage flow velocity (OR = .988; P = .009) were significant predictors for thromboembolic events in multivariate analyses. In data from the NHIS, CHA 2 DS 2 ‐VASc score did not outperform age to predict thromboembolic events. Conclusions Age is a significant risk factor for thromboembolic events in patients with AF, and old age is associated with adverse cardiac hemodynamics. This study suggests that older patients with AF are at high risk of thromboembolic events regardless of CHA 2 DS 2 ‐VASc score.