Stroke and Major Bleeding Risk in Elderly Patients Aged ≥75 Years With Atrial Fibrillation The Loire Valley Atrial Fibrillation Project

Background and Purpose—Atrial fibrillation (AF) is increasingly prevalent in the elderly, but such patients tend to be under-represented in clinical trials. Increasing age confers a higher risk of stroke and bleeding when antithrombotic therapy is used. We examined risk factors for stroke and bleeding among elderly (age, >75 years) patients within a real world hospitalized cohort from the Loire Valley AF project. Methods—We identified elderly (age, >75 years) patients with AF, assessed their risk factors, and followed up for stroke, thromboembolism, death, or major bleeding. The effect of vitamin K antagonist (VKA) use on these end points was assessed. Results—We studied 8962 patients with AF, and we identified 4130 elderly (age, ≥75 years) patients. Using Kaplan–Meier analyses, event rates of death, stroke/thromboembolism, the composite of stroke/thromboembolism/death, and major bleeding increased with increasing age. For mortality, VKA-treated patients did better than non-VKA–treated patients. The risk ...