Blood thinners tied to survival at 80 and up with atrial fibrillation
One-year mortality was 8.7% among people who continued blood thinners, versus 17.7% among those who never took them, in a retrospective cohort study.
Limit: Healthier patients could preferentially receive anticoagulation, making treatment appear protective
Edited by Boris Djordjevic · AgingResearch.News
In a retrospective cohort study, researchers analyzed synthetic electronic health records for 45,305 adults aged 80 and older with atrial fibrillation, an irregular heartbeat, from a large US health system. They compared people who continued, started, stopped or never took blood thinners, medicines that reduce blood clotting.
Continuing blood thinners was associated with lower one-year mortality than never taking them. Mortality converged across groups at five years. Bleeding in the digestive tract was more frequent among people taking blood thinners: 13.0% in the continued-use group and 11.9% in the newly started group. Bleeding inside the skull was uncommon and comparable across groups, at 1.3% to 1.6%.
Why it matters
Adults 80 and older with atrial fibrillation are underrepresented in randomized trials. The authors said the findings support continuing blood thinners in appropriately selected older patients rather than withholding them because of age alone.
Caveats
This observational study cannot show that blood thinners caused the mortality difference. It excluded people with narrowing of the mitral heart valve, mechanical heart valves, cirrhosis (liver scarring) or end-stage kidney disease.
From the paper
- Participants
After excluding patients with mitral stenosis, mechanical heart valves, cirrhosis, or end-stage renal disease (ESRD), a total of 45,305 patients were included in the final analysis.
- Result
In the primary time-varying Cox model, in which patients whose anticoagulation status changed contributed multiple time intervals (50,140 person-intervals across 45,305 patients), anticoagulation was associated with a 25% lower hazard of all-cause mortality (HR 0.75, 95% CI 0.71–0.79, p < 0.001).
- Events by group
Patients who continued anticoagulation had the lowest all-cause mortality rates at every time point: 1.5% at 30 days, 5.4% at 6 months, and 8.7% at 1 year, compared with 8.3%, 14.5% and 17.7% in the never group (all p < 0.001) (Table 2;Fig. 1).
- Limitation
First, as a retrospective analysis of administrative data, it is subject to coding errors and misclassification; although comorbidities and medication use were identified using ICD codes and prescription data, incomplete capture or coding errors cannot be entirely excluded.
Quoted word for word from the full text on link.springer.com.
- Anticoagulation
- Atrial fibrillation
- Gastrointestinal bleeding
- Intracranial hemorrhage
- Ischemic stroke
- Humans
The paper
Journal of General Internal Medicine, Oct 27, 2026, Open access
