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Q What is the effect of concomitant anticoagulant and antiplatelet treatment on the risk of major bleeding in older patients with atrial fibrillation (AF)?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Internal medicine ★★★★★★☆ Haematology ★★★★★☆☆ Cardiology ★★★★★☆☆
METHODS
Design:
retrospective cohort analysis within the US National Stroke Project.
Setting:
USA.
Patients:
10 093 patients ⩾65 years of age (mean age 77 y, 51% men) who were admitted to hospital for AF and had warfarin discharge treatment. Exclusion criteria: transfer to another acute care hospital, death during hospitalisation, or discharge against hospital advice.
Risk factors:
age, sex, comorbid conditions (coronary or valvular heart disease, diabetes, previous cerebrovascular event, hypertension, and congestive heart failure), bleeding risk factors (previous bleeding, anaemia during the index hospital admission, ulcer, risk of falls, alcohol use, hepatic disease, dementia, cancer, and concurrent medications), and warfarin use before admission.
Outcomes:
antiplatelet drug use after hospital discharge and hospital …
Footnotes
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↵* Numbers calculated from data in article.
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For correspondence: Dr T I Shireman, University of Kansas School of Pharmacy, Lawrence, KS, USA. Shiremanku.edu
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Source of funding: American Heart Association.
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