Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundWe aimed to evaluate the impact of concomitant use of oral anticoagulants (OAC) and antiplatelet drugs (APD) on clinical outcomes compared with OAC monotherapy in patients aged ≥75 years with atrial fibrillation.MethodsThe ANAFIE (All Nippon AF [Atrial Fibrillation] in Elderly) Registry was a prospective multicenter observational study in Japan.
This subanalysis included patients aged ≥75 years with nonvalvular atrial fibrillation receiving OAC. Patients were classified into OAC monotherapy and concomitant OAC+APD therapy groups.
Clinical outcomes, including stroke/systemic embolism, major bleeding, and all‐cause mortality, were compared using Cox proportional hazards models. Within the OAC+APD group, outcomes were also compared between patients using direct OACs and those using warfarin.ResultsAmong 29 818 patients (median age 81 years, 42.3% female), 4861 (16.3%) received OAC+APD therapy.
This group had higher proportion of men, previous cerebrovascular disease, and previous myocardial infarction. The group showed increased risk of cardiovascular death [1.57 versus 0.94/100 person‐years, adjusted hazard ratio (aHR), 1.29 [95% CI, 1.01–1.64].
Journal of the American Heart Association published a clinical update in Cardiology on 13 Mar 2026.
The item focuses on Impact of Combined Anticoagulant and Antiplatelet Therapy in Older Patients With Atrial Fibrillation: ANAFIE Subanalysis.
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