{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:23:53Z","timestamp":1780928633393,"version":"3.54.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100010724","name":"Health Systems Research Institute","doi-asserted-by":"publisher","award":["59-053"],"award-info":[{"award-number":["59-053"]}],"id":[{"id":"10.13039\/501100010724","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100032332","name":"Heart Association of Thailand","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100032332","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Thromb Thrombolysis"],"DOI":"10.1007\/s11239-025-03237-5","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T15:22:30Z","timestamp":1768231350000},"page":"598-609","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of biological age versus chronological age on clinical outcomes in patients with atrial fibrillation: insights from the COOL-AF registry"],"prefix":"10.1007","volume":"59","author":[{"given":"Rungroj","family":"Krittayaphong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pongsakorn","family":"Buraphat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahthit","family":"Yindeengam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chulaluk","family":"Komoltri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"3237_CR1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1093\/ehjqcco\/qcaa093","volume":"8","author":"P Burdett","year":"2022","unstructured":"Burdett P, Lip GYH (2022) Atrial fibrillation in the UK: predicting costs of an emerging epidemic recognizing and forecasting the cost drivers of atrial fibrillation-related costs. Eur Heart J Qual Care Clin Outcomes 8:187\u2013194","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"3237_CR2","doi-asserted-by":"publisher","first-page":"163","DOI":"10.26599\/1671-5411.2023.03.008","volume":"20","author":"R Krittayaphong","year":"2023","unstructured":"Krittayaphong R, Pumprueg S, Kaewkumdee P, Yindeengam A, Lip GY (2023) Three-year outcomes of patients with non-valvular atrial fibrillation: the COOL-AF registry. J Geriatric Cardiology: JGC 20:163\u2013173","journal-title":"J Geriatric Cardiology: JGC"},{"key":"3237_CR3","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.1016\/j.jacc.2018.03.019","volume":"71","author":"AB Curtis","year":"2018","unstructured":"Curtis AB, Karki R, Hattoum A, Sharma UC (2018) Arrhythmias in patients >\/=80 years of age: Pathophysiology, Management, and outcomes. J Am Coll Cardiol 71:2041\u20132057","journal-title":"J Am Coll Cardiol"},{"key":"3237_CR4","doi-asserted-by":"publisher","first-page":"707","DOI":"10.2147\/CIA.S302389","volume":"16","author":"R Krittayaphong","year":"2021","unstructured":"Krittayaphong R, Boonyapiphat T, Wongvipaporn C, Sairat P, Investigators C-A (2021) Age-Related clinical outcomes of patients with Non-Valvular atrial fibrillation: insights from the COOL-AF registry. Clin Interv Aging 16:707\u2013719","journal-title":"Clin Interv Aging"},{"key":"3237_CR5","doi-asserted-by":"publisher","first-page":"102974","DOI":"10.1016\/j.eclinm.2024.102974","volume":"78","author":"T Bucci","year":"2024","unstructured":"Bucci T, Romiti GF, Ishiguchi H et al (2024) Adverse events in clinically complex elderly patients with atrial fibrillation according to oral anticoagulation status. EClinicalMedicine 78:102974","journal-title":"EClinicalMedicine"},{"key":"3237_CR6","doi-asserted-by":"crossref","unstructured":"Kotalczyk A, Guo Y, Wang Y, Lip GYH, On Behalf Of The Chi ORI (2022) Impact of Multimorbidity and Polypharmacy on Clinical Outcomes of Elderly Chinese Patients with Atrial Fibrillation. J Clinl Med. 11","DOI":"10.3390\/jcm11051370"},{"key":"3237_CR7","doi-asserted-by":"publisher","first-page":"114064","DOI":"10.1016\/j.biopha.2022.114064","volume":"158","author":"L Mart\u00ednez-Montesinos","year":"2023","unstructured":"Mart\u00ednez-Montesinos L, Rivera-Caravaca JM, Agewall S et al (2023) Polypharmacy and adverse events in atrial fibrillation: main cause or reflection of multimorbidity? Biomed pharmacotherapy = Biomedecine Pharmacotherapie 158:114064","journal-title":"Biomed pharmacotherapy = Biomedecine Pharmacotherapie"},{"key":"3237_CR8","doi-asserted-by":"crossref","unstructured":"Goldhaber SZ, Bassand JP, Camm AJ et al (2024) Clinical Outcomes in Older Patients with Atrial Fibrillation: Insights from the GARFIELD-AF Registry. American J Med. 137:128\u2013136 e113","DOI":"10.1016\/j.amjmed.2023.10.027"},{"key":"3237_CR9","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1038\/nrcardio.2017.153","volume":"14","author":"GYH Lip","year":"2017","unstructured":"Lip GYH (2017) The ABC pathway: an integrated approach to improve AF management. Nat Reviews Cardiol 14:627\u2013628","journal-title":"Nat Reviews Cardiol"},{"key":"3237_CR10","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1055\/s-0043-1772773","volume":"124","author":"S Treewaree","year":"2024","unstructured":"Treewaree S, Lip GYH, Krittayaphong R (2024) Non-vitamin K antagonist oral Anticoagulant, Warfarin, and ABC pathway adherence on hierarchical outcomes: win ratio analysis of the COOL-AF registry. Thromb Haemost 124:69\u201379","journal-title":"Thromb Haemost"},{"key":"3237_CR11","doi-asserted-by":"crossref","unstructured":"Krittayaphong R, Treewaree S, Lip GYH (2024) Components of the Atrial fibrillation Better Care pathway for holistic care of patients with atrial fibrillation: a win ratio analysis from the COOL-AF registry. Europace: European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 26","DOI":"10.1093\/europace\/euae237"},{"key":"3237_CR12","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1055\/s-0043-1769612","volume":"123","author":"GF Romiti","year":"2023","unstructured":"Romiti GF, Guo Y, Corica B et al (2023) Mobile Health-Technology-Integrated care for atrial fibrillation: A win ratio analysis from the mAFA-II randomized clinical trial. Thromb Haemost 123:1042\u20131048","journal-title":"Thromb Haemost"},{"key":"3237_CR13","doi-asserted-by":"crossref","unstructured":"Chu M, Zhang S, Gong J et al (2025) Telemedicine-based integrated management of atrial fibrillation in village clinics: a cluster randomized trial. Nat Med 2025 Apr;31(4):1276\u20131285","DOI":"10.1038\/s41591-025-03511-2"},{"key":"3237_CR14","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1055\/a-2325-5923","volume":"124","author":"Y Wang","year":"2024","unstructured":"Wang Y, Guo Y, Qin M et al (2024) 2024 Chinese expert consensus guidelines on the diagnosis and treatment of atrial fibrillation in the Elderly, endorsed by geriatric society of Chinese medical association (Cardiovascular Group) and Chinese society of geriatric health medicine (Cardiovascular Branch): executive summary. Thromb Haemost 124:897\u2013911","journal-title":"Thromb Haemost"},{"key":"3237_CR15","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1055\/s-0041-1739411","volume":"122","author":"TF Chao","year":"2022","unstructured":"Chao TF, Joung B, Takahashi Y et al (2022) 2021 focused update consensus guidelines of the Asia Pacific heart rhythm society on stroke prevention in atrial fibrillation: executive summary. Thromb Haemost 122:20\u201347","journal-title":"Thromb Haemost"},{"key":"3237_CR16","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1055\/a-2434-9244","volume":"124","author":"T Potpara","year":"2024","unstructured":"Potpara T, Romiti GF, Sohns C (2024) The 2024 European society of cardiology guidelines for diagnosis and management of atrial fibrillation: A viewpoint from a practicing clinician\u2019s perspective. Thromb Haemost 124:1087\u20131094","journal-title":"Thromb Haemost"},{"key":"3237_CR17","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.mad.2005.10.004","volume":"127","author":"P Klemera","year":"2006","unstructured":"Klemera P, Doubal S (2006) A new approach to the concept and computation of biological age. Mech Ageing Dev 127:240\u2013248","journal-title":"Mech Ageing Dev"},{"key":"3237_CR18","doi-asserted-by":"publisher","first-page":"2795","DOI":"10.1007\/s11357-021-00480-5","volume":"43","author":"D Kwon","year":"2021","unstructured":"Kwon D, Belsky DW (2021) A toolkit for quantification of biological age from blood chemistry and organ function test data: bioage. Geroscience 43:2795\u20132808","journal-title":"Geroscience"},{"key":"3237_CR19","doi-asserted-by":"crossref","unstructured":"Schulman S, Kearon C, Subcommittee on Control of Anticoagulation of the S, Standardization Committee of the International Society on T (2005), Haemostasis: Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J thromb haemost JTH. 3:692\u2013694","DOI":"10.1111\/j.1538-7836.2005.01204.x"},{"key":"3237_CR20","doi-asserted-by":"crossref","unstructured":"Yang M, Chao K, Wang Z, Xue R, Zhang X, Wang D (2024) Accelerated biological aging and risk of atrial fibrillation: A cohort study. Heart Rhythm 2025 Oct;22(10):2507\u20132514","DOI":"10.1016\/j.hrthm.2024.11.017"},{"key":"3237_CR21","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1055\/s-0038-1651587","volume":"69","author":"FR Rosendaal","year":"1993","unstructured":"Rosendaal FR, Cannegieter SC, van der Meer FJ, Briet E (1993) A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 69:236\u2013239","journal-title":"Thromb Haemost"},{"key":"3237_CR22","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.arr.2016.06.005","volume":"29","author":"JP da Costa","year":"2016","unstructured":"da Costa JP, Vitorino R, Silva GM, Vogel C, Duarte AC, Rocha-Santos T (2016) A synopsis on aging-Theories, mechanisms and future prospects. Ageing Res Rev 29:90\u2013112","journal-title":"Ageing Res Rev"},{"key":"3237_CR23","doi-asserted-by":"publisher","first-page":"573","DOI":"10.18632\/aging.101414","volume":"10","author":"ME Levine","year":"2018","unstructured":"Levine ME, Lu AT, Quach A et al (2018) An epigenetic biomarker of aging for lifespan and healthspan. Aging 10:573\u2013591","journal-title":"Aging"},{"key":"3237_CR24","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1111\/acel.12601","volume":"16","author":"SS Khan","year":"2017","unstructured":"Khan SS, Singer BD, Vaughan DE (2017) Molecular and physiological manifestations and measurement of aging in humans. Aging Cell 16:624\u2013633","journal-title":"Aging Cell"},{"key":"3237_CR25","doi-asserted-by":"publisher","first-page":"e001937","DOI":"10.1161\/CIRCGEN.117.001937","volume":"11","author":"NS Roetker","year":"2018","unstructured":"Roetker NS, Pankow JS, Bressler J, Morrison AC, Boerwinkle E (2018) Prospective study of epigenetic age acceleration and incidence of cardiovascular disease outcomes in the ARIC study (Atherosclerosis risk in Communities). Circ Genom Precis Med 11:e001937","journal-title":"Circ Genom Precis Med"},{"key":"3237_CR26","doi-asserted-by":"crossref","unstructured":"Abugroun A, Shah SJ, Fitzmaurice G et al (2025) The Association Between Accelerated Biological Aging and Cardiovascular Outcomes in Older Adults with Hypertension. American J Med. 138:487\u2013494 e487","DOI":"10.1016\/j.amjmed.2024.10.029"},{"key":"3237_CR27","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1161\/CIRCULATIONAHA.121.056456","volume":"144","author":"JD Roberts","year":"2021","unstructured":"Roberts JD, Vittinghoff E, Lu AT et al (2021) Epigenetic age and the risk of incident atrial fibrillation. Circulation 144:1899\u20131911","journal-title":"Circulation"},{"key":"3237_CR28","doi-asserted-by":"publisher","first-page":"e14309","DOI":"10.1111\/acel.14309","volume":"23","author":"MF Wang","year":"2024","unstructured":"Wang MF, Hou C, Jia F, Zhong CH, Xue C, Li JJ (2024) Aging-associated atrial fibrillation: A comprehensive review focusing on the potential mechanisms. Aging Cell 23:e14309","journal-title":"Aging Cell"},{"key":"3237_CR29","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1186\/s12916-024-03769-2","volume":"22","author":"Z Zhu","year":"2024","unstructured":"Zhu Z, Lyu J, Hao X et al (2024) Estimation of physiological aging based on routine clinical biomarkers: a prospective cohort study in elderly Chinese and the UK biobank. BMC Med 22:552","journal-title":"BMC Med"},{"key":"3237_CR30","doi-asserted-by":"publisher","first-page":"117609","DOI":"10.1016\/j.bone.2025.117609","volume":"200","author":"R Zhang","year":"2025","unstructured":"Zhang R, Zhong W, Gao Y, Duan X, Ye Q (2025) Biological age acceleration predicts osteoporosis and reduced longevity in a large prospective cohort. Bone 200:117609","journal-title":"Bone"},{"key":"3237_CR31","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1007\/s40520-025-03038-z","volume":"37","author":"LS Zeng","year":"2025","unstructured":"Zeng LS, Wu YT, Zhang FP (2025) The association between dietary quality and biological aging: two-mediation analysis. Aging Clin Exp Res 37:130","journal-title":"Aging Clin Exp Res"},{"key":"3237_CR32","doi-asserted-by":"crossref","unstructured":"Kim MH, Yang PS, Kim D et al (2025) Racial differences and similarities in atrial fibrillation epidemiology and risk factors in UK biobank and Korean NHIS-HEALS cohort studies. Heart Rhythm 2025 Aug;22(8):e277\u2013e284","DOI":"10.1016\/j.hrthm.2025.02.013"},{"key":"3237_CR33","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1055\/a-2269-1123","volume":"124","author":"DS Kang","year":"2024","unstructured":"Kang DS, Yang PS, Kim D et al (2024) Racial differences in bleeding risk: an ecological epidemiological study comparing Korea and united Kingdom subjects. Thromb Haemost 124:842\u2013851","journal-title":"Thromb Haemost"},{"key":"3237_CR34","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1055\/a-2278-8769","volume":"124","author":"DS Kang","year":"2024","unstructured":"Kang DS, Yang PS, Kim D et al (2024) Racial differences in ischemic and hemorrhagic stroke: an ecological epidemiological study. Thromb Haemost 124:883\u2013892","journal-title":"Thromb Haemost"}],"container-title":["Journal of Thrombosis and Thrombolysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11239-025-03237-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11239-025-03237-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11239-025-03237-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:41:19Z","timestamp":1780926079000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11239-025-03237-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["3237"],"URL":"https:\/\/doi.org\/10.1007\/s11239-025-03237-5","relation":{},"ISSN":["1573-742X"],"issn-type":[{"value":"1573-742X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"7 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"GYHL: Consultant and speaker for BMS\/Pfizer, Boehringer Ingelheim, and Daiichi-Sankyo. No fees are directly received personally. He is co-PI of the AFFIRMO project on multimorbidity in AF (grant agreement No 899871), TARGET project on digital twins for personalised management of atrial fibrillation and stroke (grant agreement No 101136244) and ARISTOTELES project on artificial intelligence for management of chronic long term conditions (grant agreement No 101080189), which are all funded by the EU\u2019s Horizon Europe Research & Innovation programme. Other authors hereby declare no personal or professional conflicts of interest relating to any aspect of this particular study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}