{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:56:47Z","timestamp":1791647807131,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T00:00:00Z","timestamp":1573776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003646","name":"National Health Insurance Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003646","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Age is a well\u2010established risk factor for thromboembolic events in patients with atrial fibrillation (AF). However, the mechanism underlying the association between age and thromboembolic events in AF remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The prognostic value of age as a risk factor for thromboembolic events was analyzed using data from the Korean National Health Insurance Service (NHIS). In a large\u2010scale single\u2010center registry, cardiac hemodynamic parameters were examined to elucidate the cause of increased risk of thromboembolic events in older patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NHIS sample cohort data including 5896 patients with AF revealed that the risk of thromboembolic complication differed significantly according to age despite equal CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score. In the registry of 2801 patients, age showed significant correlations with left atrium (LA) diameter, LA volume, E\/e\u2032, pulmonary artery pressure, and LA appendage flow velocity. Older patients had a significantly higher prevalence of spontaneous echocontrast (odds ratio [OR] = 1.030; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Age (OR = 1.031; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), E\/e\u2032 (OR = 1.065; <jats:italic>P<\/jats:italic> = .004), and LA appendage flow velocity (OR = .988; <jats:italic>P<\/jats:italic> = .009) were significant predictors for thromboembolic events in multivariate analyses. In data from the NHIS, CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score did not outperform age to predict thromboembolic events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Age is a significant risk factor for thromboembolic events in patients with AF, and old age is associated with adverse cardiac hemodynamics. This study suggests that older patients with AF are at high risk of thromboembolic events regardless of CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>\u2010VASc score.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23293","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T13:09:59Z","timestamp":1573823399000},"page":"78-85","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Impact of age on thromboembolic events in patients with non\u2010valvular atrial fibrillation"],"prefix":"10.1002","volume":"43","author":[{"given":"Yun Gi","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6617-508X","authenticated-orcid":false,"given":"Jong\u2010Il","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Yung","family":"Boo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeji","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Medical Statistics Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Medical Statistics Korea University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7430-415X","authenticated-orcid":false,"given":"Kwang\u2010No","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaemin","family":"Shim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Korea University Medicine Anam Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61514-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60040-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20136"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2004.06.030"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.22.2864"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d124"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.09.012"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191648"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000040"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx103"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.966713"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20232"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013880"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021047"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-43283-7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.148.3.6878708"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1635084"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22596"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.026"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy837"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.11.046"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.10.052"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.23293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.23293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T09:38:45Z","timestamp":1694165925000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.23293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,15]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/clc.23293"],"URL":"https:\/\/doi.org\/10.1002\/clc.23293","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,15]]},"assertion":[{"value":"2019-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}