Abstract: Objective To evaluate the relationship between discontinuation of oral anticoagulants(OAC) use and clinical outcomes in the elderly patients with atrial fibrillation through long-term follow-up. Methods The elderly patients aged ≥75 years with non-valvular atrial fibrillation(NVAF) who had been prescribed OAC at Xuzhou Central Hospital from July 2018 to December 2020 were enrolled in this study. Demographic and clinical data of the patients were collected, and long-term follow-up was conducted through outpatient clinics and telephone calls. The composite outcome was stroke or all-cause death. Multivariate Cox regression model was used to analyze the relevant factors of clinical prognosis. Results A total of 560 patients with a median age of 80(78, 84) years were enrolled in the study. During a mean follow-up period of 33 months, 262 patients(46.8%) discontinued anticoagulant therapy. The discontinuation group had a significantly higher incidence of endpoint events during the follow-up period than the continuation group(46.9% vs. 25.2%,P＜0.01). Multivariate Cox analysis showed that discontinuation of anticoagulant therapy was an independent risk factor for endpoint events(HR=1.74, 95%CI:1.29-2.34,P＜0.01). Conclusions Nearly half of elderly NVAF patients who had received anticoagulation therapy discontinued OAC during long-term follow-up, and discontinuation of anticoagulation shows effects on poor clinical long-term prognosis.

Key words: non-valvular atrial fibrillation, aged, oral anticoagulant, treatment discontinuation, clinical prognosis