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Comment on: Differential effect of anticoagulation according to cognitive function and frailty in older patients with atrial fibrillation by Chukwuma Okoye; Cristina Cargiolli; Giulia Pescatore is a Medicine article available to read on EtoBox.

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Differential effect of anticoagulation according to cognitive function and frailty in older patients with atrial fibrillation To the Editor: We read with interest the recent paper by Dr. Wang et al. highlighting outcomes differences according to physical and cognitive frailty of older patients with atrial fibrillation (AF) receiving or not oral anticoagulant therapy (OAT). The authors found cognitive impairment as an independent risk factor for the composite outcome of major bleeding and death, thus, indicating dementia as a deciding component for the anticoagulation prescription. Although current guidelines suggest avoiding OAT prescription on very frail older patients with AF, 2 based on Dr. Wang and colleagues' findings, the presence of frailty syndrome does not appear to be associated with an increased risk of major bleeding or death at the 2-year follow-up. This seems to contradict a recent study published in JAGS by Candeloro et al., showing an increased bleeding risk with advancing frailty degree in older outpatients with AF.In our opinion, this finding could be explained by the author's decision to include pre-frail and no-frail patients in a unique entity even though pre-f

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Author

Chukwuma Okoye; Cristina Cargiolli; Giulia Pescatore

Publisher

John Wiley and Sons; The American Geriatrics Society; Wiley (Blackwell Publishing); Blackwell Publishing Inc.; Wiley (ISSN 0002-8614)

Published

2023

Language

EN

Field

Medicine (Health Sciences)