Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation

Elaine M. Hylek, Carmella Evans-Molina, Carol Shea, Lori E. Henault, Susan Regan

Research output: Contribution to journalArticle

806 Citations (Scopus)

Abstract

BACKGROUND - Warfarin is effective in the prevention of stroke in atrial fibrillation but is under used in clinical care. Concerns exist that published rates of hemorrhage may not reflect real-world practice. Few patients ≥80 years of age were enrolled in trials, and studies of prevalent use largely reflect a warfarin-tolerant subset. We sought to define the tolerability of warfarin among an elderly inception cohort with atrial fibrillation. METHODS AND RESULTS - Consecutive patients who started warfarin were identified from January 2001 to June 2003 and followed for 1 year. Patients had to be ≥65 years of age, have established care at the study institution, and have their warfarin managed on-site. Outcomes included major hemorrhage, time to termination of warfarin, and reason for discontinuation. Of 472 patients, 32% were ≥80 years of age, and 91% had ≥1 stroke risk factor. The cumulative incidence of major hemorrhage for patients ≥80 years of age was 13.1 per 100 person-years and 4.7 for those

Original languageEnglish (US)
Pages (from-to)2689-2696
Number of pages8
JournalCirculation
Volume115
Issue number21
DOIs
StatePublished - May 2007
Externally publishedYes

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Warfarin
Atrial Fibrillation
Hemorrhage
Therapeutics
Stroke
Incidence

Keywords

  • Anticoagulants
  • Atrial fibrillation
  • Hemorrhage
  • Stroke

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. / Hylek, Elaine M.; Evans-Molina, Carmella; Shea, Carol; Henault, Lori E.; Regan, Susan.

In: Circulation, Vol. 115, No. 21, 05.2007, p. 2689-2696.

Research output: Contribution to journalArticle

Hylek, Elaine M. ; Evans-Molina, Carmella ; Shea, Carol ; Henault, Lori E. ; Regan, Susan. / Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. In: Circulation. 2007 ; Vol. 115, No. 21. pp. 2689-2696.
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