Atrial fibrillation in the elderly and long-livers: a retrospective analysis of the clinical profile of patients using artificial intelligence

• Published in: Kardiovaskuli͡a︡rnai͡a︡ terapii͡a︡ i profilaktika Vol. 22; no. 7; p. 3606
• Main Authors: Druzhilov, M. A., Kuznetsova, T. Yu
• Format: Journal Article
• Language: English; Russian
• Published: SILICEA-POLIGRAF» LLC 04-09-2023
• Subjects: anticoagulant therapy; atrial fibrillation; clinical characteristics; long-livers; old age
• ISSN: 1728-8800; 2619-0125
• DOI: 10.15829/1728-8800-2023-3606

Aim.
Retrospective analysis of the clinical characteristics of elderly patients with atrial fibrillation (AF) and long-livers in individual subjects of the Russian Federation using artificial intelligence.
Material and methods
. The information was obtained from the Webiomed predictive analytics platform. The main database included 144431 patients with AF who received care in medical organizations in 6 constituent entities of the Russian Federation in the period 2016-2019. Of these, 56830 (39,3%) persons were aged ≥75 years: 47595 aged 75-89 years, 9235 aged ≥90 years.
Results.
Patients with AF aged ≥75 years compared with persons aged 18-74 years were characterized by a significantly higher incidence of hypertension, type 2 diabetes, estimated glomerular filtration rate <60 ml/min/1,73 m
2
, heart failure and peripheral atherosclerosis, thromboembolic (TEE), atherothrombotic and hemorrhagic events. The prescription rate of anticoagulant therapy (ACT) was 29,6% and was lower (p<0,001) compared with a subgroup of people with AF aged 1874 years with a high risk of TEE (41,2%). Among patients with AF aged ≥75 years, in 9,4% of cases, no additional (in relation to age and sex) CHA2DS2-VASc points were found, and in 1/3 of individuals there was only one additional points. With an increase CHA2DS2-VASc score in these patients, the ACT prescription rate increased from 13 to 55,5%. The prescription rate of acetylsalicylic acid was 12,8%. Only 33% of people with AF aged ≥75 years who had an ischemic stroke were prescribed ACT.
Conclusion.
The retrospective analysis indicates a high proportion of people aged ≥75 years in the structure of all patients with AF. This group is characterized by a significant comorbidity, a high TEE risk, hemorrhagic and atherothrombotic events. At the same time, the ACT prescription rate as of 2016-2019 in individual subjects of the Russian Federation did not meet the requirements of the clinical guidelines.