For patients with vaginal fibrillation, the risk of stroke or heart attack from interruption usually exceeds the risk of bleeding, according to new findings at the University of Bath.
Clinicians are often concerned about the dangers of prescribing blood thinning drugs in elderly patients due to concerns about falls and significant bleeding, however new research by the University of Bath – funded by Dunhill Medical Confidence – indicates that for patients Cardiac Status Vaginal Status Fibrillation (AF), Risks to Health of Non -Download These drugs are significantly higher than the risk of a life -threatening bleeding.
AF It is associated with a five -fold increase in stroke risk, with estimates suggesting that the situation contributes to 20,000 strokes per year in the United Kingdom. It also increases the risk of heart attacks and death. Blood dilutics – otherwise known as anticoagulants – are particularly effective in managing AF and prevention of strokes and other complications.
The elderly also tend to fall more frequently, with falls being the leading cause of an injury between adults aged 65 years or older. These can lead to serious injuries, such as hip fractures and head injuries.
However the new study, published today HeartHe found that in contrast to folk medical belief, the interruption of anticoagulants for patients aged 75 or older does not change the risk of high bleeding. These findings are important for clinical doctors to calculate their behavior, according to study authors.
“Prescriptionists need to consider the increased risk for patients coming from anticoagulants, including the stroke,” said Dr. Anneka Mitchell, who conducted research by the University of Bath and is a Visiting Researcher at the University of Science.
Rising cases
AF cases are increased in all age groups, but especially among people aged 85 and over. In this age group, the number of people diagnosed with the situation doubled in men from 11.6% to 22.1% between 2000 and 2016 and increased in women from 9.6% to 16.5%. There are no data available to display trends from 2016.
Although there is much of the elements to support the use of diluctive blood for the elderly with AF, the new study is believed to be the first to measure the results of patients when anticoagulant medication stops.
The study of Dr. Mitchell has analyzed data from the United Kingdom Clinical Practical Research Datalink (a research set including anonymous patient data from certain UK general practices between 2013 and 2017, focusing on patients aged 75 and over, who had recently been prescribed anticoagulants.
He found that the risks of the stroke and death were three times higher during periods during which patients did not receive anticoagulant treatment. The risk of heart attacks was almost double compared to the periods during which patients were treated with anticoagulants.
Warfarin against direct oral anticoagulants
Dr. Mitchell-who is associated with UK UK, the Bath-based Institute of Charity and Research and also works as a clinical pharmacist at University Hospitals Plymouth NHS Trust-believes that, as well as concern for falls, many clinicians them to withhold anticoagulants about the historical experience of patients who They received anticoagulant warfarin.
This medicine-the only option available for the treatment of AF by 2012-is associated with a complex medication drug, along with dietary restrictions and frequent blood tests, making treatment difficult for many elderly patients.
Since 2013, however, a new family of drugs called oral direction has become the first choice for most patients. Doacs are just as effective and safe with warfarin – sometimes more – and much simpler to get.
For example, Apixaban (DOAC) has a lower risk of significant bleeding than warfarin, so for many older patients with AF, this would be an excellent drug.
Our findings emphasize the critical need for clinicians to carefully examine the dangers of interruption of anticoagulant treatment in elderly patients. Despite concerns about bleeding, this study suggests that interruption of anticoagulant treatment does not significantly affect the risk of high bleeding, but increases the risk of serious events such as stroke and death. “
Dr. Anneka Mitchell
He added: “Both the risks and the benefits of medication must be fully discussed with patients before the interruption of the prescription physician so that both the doctor and the patient make a joint and documented decision. This study underlines the importance of evaluating the consequences of the mission. negative results. “
Affecting the lives of older patients
Dr. Anita McGrogan who led the research team from the Bath Life Department, said: “Elderly patients were poorly represented in clinical trials that evaluated the effectiveness and safety of Doacs before these products were licensed and those included were healthier by many people in the target group for prescription. People.
“This study has caused significant results that will have an impact on patients in the future. It has completed the gap of information by examining anonymous data in 20,167 people over 75 years old, collected by GPS. It clearly shows the value of using large data to be significantly explored Clinical questions, especially in vulnerable populations.
Dr. Tomas Welsh, a Royal United Hospitals Bath and Research & Medical Director at Refind, hopes that the new study will provide both clinics and patients with better data to inform their decisions about anticoagulants. He noted that, so far, clinicians who advise patients to stop taking blood diluted have not been able to quantify the increased risk of stroke.
“These data help patients and clinical doctors have a more steady understanding of the risks exposed, “he said.
Dr. Welsh also stressed that the younger generation’s bloodthirsty blood was not always the right course of action for the weak, the elderly.
“Suspension of any medicine or reducing the use of multiple drugs in an older patient is always a subtle and individual discussion,” he said.
Source:
Magazine report:
Mitchell, A., et al. (2025) Safety and efficacy of anticoagulant treatment in elderly people with vaginal fibrillation during exposed and non -exposed treatment periods. Heart. doi.org/10.1136/heartjnl-2024-324763.
