Impact of age on thromboembolic events in patients with non-valvular atrial fibrillation

Yun Gi Kim, Jong Il Choi, Ki Yung Boo, Do Young Kim, Yeji Hong, Min Sun Kim, Kwang No Lee, Jaemin Shim, Jin Seok Kim, Young Hoon Kim

Research output: Contribution to journalArticle

Abstract

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 CHA2DS2-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, CHA2DS2-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 CHA2DS2-VASc score.

Original languageEnglish
Pages (from-to)78-85
Number of pages8
JournalClinical Cardiology
Volume43
Issue number1
DOIs
Publication statusPublished - 2020 Jan 1

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Keywords

  • age
  • atrial fibrillation
  • ischemic stroke
  • thromboembolic complication
  • transient ischemic attack

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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