{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:35:52Z","timestamp":1791596152510,"version":"4.3.4"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Older age increases the risk of thromboembolism (TE) and major bleeding in atrial fibrillation (AF) patients, but limited evidence exists regarding the older population (age\u2009\u2265\u200980) especially from different global regions. Data on benefits of oral anticoagulants in these very old individuals are also limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From the prospective, multicenter Global Registry on Long-Term Antithrombotic Treatment in Patients with Atrial Fibrillation registry, we analysed by age all-cause death, cardiovascular death, major adverse cardiovascular events (MACE), TE, major bleeding, stroke, and myocardial infarction (MI) over 3-years follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 7652 patients aged \u226575\u00a0years (age 80.1\u2009\u00b1\u20093.9\u00a0years, 47.1% male), 4006 were\u2009\u2265\u200980\u00a0years (age 83.4\u2009\u00b1\u20093.9\u00a0years, 43.5% male). After multivariable adjustment, older patients had a higher risk of all-cause death (HR:1.94, 95% CI: 1.67\u20132.27), cardiovascular death (HR: 2.17, 95% CI: 1.71\u20132.74), MACE (HR: 1.57, 95% CI: 1.32\u20131.86), TE (HR: 1.45, 95% CI: 1.14\u20131.83), major bleeding (HR: 1.30, 95% CI: 1.04\u20131.63), stroke (HR: 1.38, 95% CI: 1.06\u20131.80) and MI (HR: 1.59, 95% CI:1.14\u20132.22). Compared with VKA, NOAC use in patients \u226580\u00a0years was associated with lower risks of all-cause death (HR: 0.79, 95% CI: 0.65\u20130.97), cardiovascular death (HR: 0.70, 95% CI: 0.51\u20130.96), MACE (HR: 0.72, 95% CI: 0.56\u20130.92), and major bleeding (HR: 0.66, 95% CI: 0.48\u20130.92). NOACs were more beneficial than warfarin for mortality, MACE and major bleeding in frail patients. The risk of clinical events associated with older patients was primarily seen in Europe and Asia (p-interaction\u2009&amp;gt;\u20090.05), but the effectiveness and safety of NOACs vs. warfarin was consistent across regions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Older age was independently associated with higher risk of death, major bleeding, TE and MACE. Compared with VKA, NOACs show improved effectiveness and safety in the older and patients with frailty, with similar efficacy across regions and ethnic groups.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf139","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T05:12:28Z","timestamp":1749013948000},"source":"Crossref","is-referenced-by-count":5,"title":["Long-term clinical outcomes of oral anticoagulation in the older patients with atrial fibrillation aged \u226580\u00a0years: a report from the GLORIA-AF registry phase III"],"prefix":"10.1093","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-8725","authenticated-orcid":false,"given":"Hongyu","family":"Liu","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Genetic Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , NO.1, MINDE ROAD, Nanchang, Jiangxi 330006 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Huang","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University , Chongqing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven Ho Man","family":"Lam","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-8942","authenticated-orcid":false,"given":"Giulio Francesco","family":"Romiti","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Translational and Precision Medicine, University of Rome La Sapienza , Rome, Lazio ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , Nanchang, Jiangxi ,","place":["China"]},{"name":"Jiangxi Provincial Key Laboratory of Molecular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University . Nanchang, Jiangxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Olshansky","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The University of Iowa , Iowa City, IO ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno","family":"Huisman","sequence":"additional","affiliation":[{"name":"Department of Medicine \u2013 Thrombosis and Hemostasis, Leiden University Medical Center , Leiden, Zuid-Holland ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , Nanchang, Jiangxi ,","place":["China"]},{"name":"Jiangxi Provincial Key Laboratory of Molecular Medicine, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University . Nanchang, Jiangxi ,","place":["China"]},{"name":"Department of Medical Genetics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University , Nanchang, Jiangxi ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tze-Fan","family":"Chao","sequence":"additional","affiliation":[{"name":"Cardiology Department, Taipei Veterans General Hospital , Taipei ,","place":["Taiwan"]},{"name":"Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University , Taipei, Taiwan Province ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool L7 8TX 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