Extract

Background: Decision-making for anticoagulation in atrial fibrillation (AF) needs to balance the risk of ischaemic stroke against the risk of major bleeding. The risk of bleeding remains a major concern of anticoagulant treatment in elderly patients. However, limited evidences are currently available on predictors of major bleeding in AF patients aged 90 years or older.

Purpose: The aim of this study was to investigate for predictors of major bleeding in AF patients aged 90 years or over while on anticoagulant treatment.

Methods: This multicenter cohort study enrolled AF patients aged 90 years or older treated with either vitamin-K antagonists (VKAs) or direct oral anticoagulants. Cox proportional hazard model was used to identify univariate predictors of major bleeding among the following: sex, age, type of anticoagulant, anticoagulation naïve, laboratory exams (haemoglobin and platelet values, Cockroft-Gault clearance), risk of falls, HAS-BLED and CHA2DS2-VASc score and their individual components. Multivariate analyses were constructed from the set of significant (p<0.50) univariable predictors.

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