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Bleeding Rates in Elderly A-Fib Patients on Warfarin Assessed

Study suggests older patients on warfarin can maintain a relatively low risk of major bleeding

FRIDAY, Sept. 4 (HealthDay News) -- With careful management, elderly patients with atrial fibrillation may be able to use oral anticoagulant treatment while maintaining a reasonably low risk of major bleeding complications, according to research published in the Sept. 8 issue of the Journal of the American College of Cardiology.

Daniela Poli, M.D., of the University of Florence in Italy, and colleagues analyzed data from 783 patients with atrial fibrillation taking warfarin for oral anticoagulant treatment, with a median age at enrollment of 75 years. Subjects were followed for an average of 2.7 years to assess rates of bleeding in those over and under 80 and factors associated with bleeding.

The researchers found that patients spent 71 percent of their time within the intended therapeutic range of an international normalized ratio of two to three, with no difference seen in subjects below and above 80 years of age. Patients under the age of 80 were less likely to have major hemorrhage than those 80 or older (rate of 0.9 versus 1.9 times 100 patient/years); however, the rate in older patients was not excessively high, the authors write. Patients with a history of previous cerebral ischemic event had a higher risk of bleeding.

"Our study shows that in elderly patients with atrial fibrillation administered warfarin, the risk of bleeding is acceptably low. This finding suggests that patients greater than or equal to 80 years of age could receive benefit from warfarin prophylaxis when a good quality of anticoagulation is obtained," Poli and colleagues conclude.

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