Some of the risk factors for anticoagulation-related bleeding are also indications for the use of anticoagulants in AF patients .
Atrial fibrillation ( AF ) is associated with an increased stroke risk that may be reduced by therapeutic anticoagulation .
However , anticoagulation is associated with an increased risk of bleeding that in some patients may outweigh the benefits in reducing the risk of stroke .
Age and the risk of warfarin-associated hemorrhage: the anticoagulation and risk factors in atrial fibrillation study.
OBJECTIVES To assess whether older age is independently associated with hemorrhage risk in patients with atrial fibrillation , whether or not they are taking warfarin therapy . DESIGN Cohort study . SETTING Integrated healthcare delivery system . Thirteen thous and five hundred fifty-nine adults with nonvalvular atrial fibrillation . MEASUREMENTS Patient data were collected from automated clinical and administrative data bases using previously vali date d search algorithms . Medical charts were review ed from patients hospitalized were for major hemorrhage ( intracranial , fatal , requiring > or=2 units of transfused blood , or involving a critical anatomic site ) . Age was categorized into four categories ( < 60 , 60 - 69 , 70 - 79 , and > or=80 ) , and multivariable Poisson regression was used to assess whether major hemorrhage rates increased with age , stratified by warfarin use and adjusted for other clinical risk factors for hemorrhage . RESULTS A total of 170 major hemorrhages were identified during 15,300 person-years of warfarin therapy and 162 major hemorrhages during 15,530 person-years off warfarin therapy . Hemorrhage rates rose with older age , with an average increase in hemorrhage rate of 1.2 ( 95 % confidence interval ( CI ) 1.0 - 1.4 ) per older age category in patients taking warfarin and 1.5 ( 95 % CI=1.3 - 1.8 ) in those not taking warfarin .  Intracranial hemorrhage rates were significantly higher in those aged 80 and older ( adjusted rate ratio=1.8 , 95 % CI=1.1 - 3.1 for those taking warfarin , adjusted rate ratio=4.7 , 95 % CI=2.4 - 9.2 for those not taking warfarin ) than in those younger than 80 . CONCLUSION Older age increases the risk of major hemorrhage , particularly intracranial hemorrhage , in patients with atrial fibrillation , whether or not they are taking warfarin .  Hemorrhage rates were generally comparable with those reported in previous r and omized trials , indicating that carefully monitored warfarin therapy can be used with reasonable safety in older patients
Some of the risk factors for anticoagulation-related bleeding are also indications for the use of anticoagulants in AF patients .
Atrial fibrillation ( AF ) is associated with an increased stroke risk that may be reduced by therapeutic anticoagulation .
However , anticoagulation is associated with an increased risk of bleeding that in some patients may outweigh the benefits in reducing the risk of stroke .