Thrombosis Research
Volume 121, Issue 3 , Pages 347-352 , 2007

Risk of bleeding in very old atrial fibrillation patients on warfarin: Relationship with ageing and CHADS2 score

  • Daniela Poli

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
    • Corresponding Author InformationCorresponding author. Centro di Riferimento Regionale per la Trombosi, Azienda Ospedaliera Universitaria Careggi, V.le Morgagni 85 - 50134 Firenze, Italy. Tel.: +39 055 7949433; fax: +39 055 7949418.
  • ,
  • Emilia Antonucci

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Rossella Marcucci

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Cinzia Fatini

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Brunetto Alterini

      Affiliations

    • SOD Medicina e Riattivazione-Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Lucia Mannini

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Michela Falciani

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Rosanna Abbate

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Gian Franco Gensini

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
  • ,
  • Domenico Prisco

      Affiliations

    • Department of Critical Care Medicine, Thrombosis Centre, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy

Received 1 November 2006 ,Revised 2 May 2007 ,Accepted 13 May 2007.

References 

  1. Wyse DG, Waldo AL, Di Marco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–1833
  2. Levine MN, Raskob G, Beyth RJ, Kearon C, Schulman S. Hemorrhagic complications of anticoagulant treatment. Chest. 2004;126:287S–310S
  3. Iliceto S. A guide to oral anticoagulant therapy : recommendation of Italian Federation of Anticoagulation Clinics. Haematologica. 2003;88(suppl 2):1
  4. Singer DE, Albers GW, Dalen JE, Go AS, Halperin JL, Manning WJ. Antithrombotic therapy in atrial fibrillation: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:429S–456S
  5. Gage BF, Gage BF, van Walraven C, Pearce L, Hart RG, Koudstaal PJ, et al. Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004;110:2287–2292
  6. Fihn SD, Callahan CM, Martin DC, McDonell MB, Henikoff JG, White RH. The risk for and severity of bleeding complications in elderly patients treated with warfarin. The National Consortium of Anticoagulation Clinics. Ann Intern Med. 1996;124:970–979
  7. Palareti G, Hirsh J, Legnani C, Manotti C, D'Angelo A, Pengo V, et al. Oral anticoagulation treatment in the elderly: a nested, prospective, case-control study. Arch Intern Med. 2000;160:470–478
  8. Hylek EM, Singer DE. Risk factors for intracranial hemorrhage in outpatients taking warfarin. Ann Intern Med. 1994;120:897–902
  9. Mariani G, Manotti C, Dettori AG. A computerized regulation of dosage in oral anticoagulant therapy. Res Clin Lab. 1990;20:119–125
  10. Rosendaal FR, Cannegieter SC, van der Meer FJM, Briet E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost. 1993;69:236–239
  11. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2002;26:S5–S20
  12. Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2000;285:2864–2870
  13. Rothman KJ. Epidemiology. In: Chap. 3. Oxford: Oxford University Press; 2002;p. 46–49
  14. Landefeld CS, Goldman L. Bleeding in outpatients treated with warfarin: relation to the prothrombin time and important remediable lesions. Am J Med. 1989;87:153–159
  15. Hylek EM, Go AS, Chang Y, Jensvold NG, Henault LE, Selby JV, et al. Effect of intensity of oral anticoagulation on stroke severity and mortality in atrial fibrillation. N Engl J Med. 2003;349:1019–1026
  16. Fang MC, Chang Y, Hylek EM, Rosand J, Greenberg SM, Go AS, et al. Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation. Ann Intern Med. 2004;141:745–752
  17. Poli D, Antonucci E, Lombardi A, Cecchi E, Gensini GF, Abbate R, et al. Prisco D Management of oral anticoagulant therapy in the real practice of an anticoagulation clinic: focus on atrial fibrillation. Blood Coagul Fibrinolysis. 2005;16:491–494
  18. Stroke Prevention in Atrial Fibrillation Investigators. Bleeding during antithrombotic therapy in patients with atrial fibrillation. Arch Intern Med. 1996;156:401–416
  19. Pengo V, Legnani C, Noventa F, Palareti G. ISCOAT Study Group (Italian Study on Complications of Oral anticoagulant Therapy). Oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and risk of bleeding. A multicentre inception cohort study. Thromb Haemost. 2001;85:418–422
  20. Gage BF, Birman-Deych E, Kerzner R, Radford MJ, Nilasena DS, Rich MW. Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall. Am J Med. 2005;118:612–617
  21. Hart RG, Boop BS, Anderson DC. Oral anticoagulants and intracranial hemorrhage. Facts and hypotheses. Stroke. 1995;26:1471–1477
  22. Saloheimo P, Juvela S, Hillbom M. Use of aspirin, epistaxis, and untreated hypertension as risk factors for primary intracerebral hemorrhage in middle-aged and elderly people. Stroke. 2001;32:399–404
  23. Hart RG, Tonarelli SB, Pearce LA. Avoiding central nervous system bleeding during antithrombotic therapy: recent data and ideas. Stroke. 2005;36:1588–1593
  24. Lip GY, Edwards SJ. Stroke prevention with aspirin, warfarin and ximelagatran in patients with non-valvular atrial fibrillation: a systematic review and meta-analysis. Thromb Res. 2006;118:321–333

PII: S0049-3848(07)00219-8

doi: 10.1016/j.thromres.2007.05.014

Thrombosis Research
Volume 121, Issue 3 , Pages 347-352 , 2007