Older patients with atrial fibrillation have higher rates of major hemorrhage in the brain whether or not they are using a common blood thinning therapy, according to a new study.
The research was conducted by a team of investigators from the University of California, San Francisco, Massachusetts General Hospital, the Division of Research at Kaiser Permanente, and Boston University School of Medicine.
Using a sample of 13,559 patients with atrial fibrillation, which is rapid irregular contractions of the heart, researchers examined how rates of major hemorrhage changed with age. They found older age is an independent risk factor for developing bleeding in the body, and in particular bleeding in the brain, known as intracranial hemorrhage. Their findings are reported in the August 10 issue of the Journal of the American Geriatrics Society.
Atrial fibrillation is the most common cardiac arrhythmia and a major risk factor for stroke. Prior studies have shown that anticoagulation medication , such as warfarin, substantially reduces the risk of atrial fibrillation-related stroke, but also increases the risk for hemorrhage.
"Our findings show that although older patients have a greater risk for hemorrhage, the overall likelihood of hemorrhage on warfarin is relatively small, especially when one considers the benefits of stroke prevention," said lead author Margaret Fang, MD, MPH, assistant professor of medicine and hospitalist at UCSF Medical Center. "Carefully monitored warfarin therapy can be used with reasonable safety in older patients."