Frailty as a Predictor of Net Clinical Benefit in Atrial Fibrillation Patients Over 60 Receiving Anticoagulants: Insights from the Single-Center Prospective REGATTA-2 Registry

Studying the frailty in patients with atrial fibrillation (AF) is essential given the high prevalence of AF and the escalating risk of strokes and bleeding as individuals age. AIM : to evaluate the effect of frailty on the risk of the sum of thromboembolic events and bleedings in patients with AF aged 60 years and older receiving anticoagulants. MATERIALS AND METHODS . This fragment from the single-center prospective REGATTA-2 register (Register of long-term Antithrombotic therapy -NCT043447187) included 455 patients with AF ≥ 60 years for whom it was possible to assess the signs of frailty on three scales Groningen Frailty Index, FRAIL and «Age is not a hindrance». During the follow-up (median of 6 years), the sum of thromboembolic events and bleedings were taken into. RESULTS . Frailty according to the Groningen Frailty Index and FRAIL scales were detected in 29.7% and 31.8%, using the «Age is not a hindrance» scale — in 9.5% of patients. The most common syndromes were emotional and cognitive disorders, fatigue and limited mobility. According to the ROC analysis, all three scales used had predictive value in relation to the risk of the sum of thromboembolic events and bleedings. Independent predictors (Cox proportional risks model) of sum of thromboembolic events and bleedings are Groningen Frailty Index ≥ 4 (HR=1.8) and «Age is not a hindrance» ≥ 3 (HR=1.6). CONCLUSION . Frail patients with atrial fibrillation have an increased risk thromboembolic events and bleedings; therefore, they need personalized monitoring and treatment regimen.