Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 17, Number 3, June 2026, pages 149-155

Nonvalvular Atrial Fibrillation and Anticoagulation in the Elderly: A Retrospective Cohort Study

↓ **Table 1.** Demographic and Clinical Characteristics
	Overall (n = 6,386)	Age 50–75 (n = 3,306)	Age 76–89 (n = 3,080)	P value
^aData are presented as median (Q1–Q3). ^bData are presented as n (%). GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; HFrEF: heart failure with reduced ejection fraction; HFpEF: heart failure with preserved ejection fraction; HTN: hypertension.
Age^a	75 (67–81)	67 (62–72)	81 (79–85)
CHA₂DS₂-VASc^a score	3 (2.0–4.0)	2 (1.0–3.0)	4 (3.0–4.0)	< 0.0001
GFR^a	55 (34–76)	61 (37–82)	50 (32–68)	< 0.0001
ORBIT score^a	2 (1.0–3.0)	1 (0–2)	2 (1.0–3.0)	< 0.0001
Active bleeding^b				0.0013
No	5,770 (90.35%)	3,025 (91.5%)	2,745 (89.12%)
Yes	616 (9.65%)	281 (8.5%)	335 (10.88%)
Antiplatelet use^b				0.0023
No	5,309 (83.13%)	2,794 (84.51%)	2,515 (81.66%)
Yes	1,077 (16.87%)	512 (15.49%)	565 (18.34%)
History of bleeding^b				0.556
No	4,447 (69.64%)	2,313 (69.96%)	2,134 (69.29%)
Yes	1,939 (30.36%)	993 (30.04%)	946 (30.71%)
HFrEF or HFpEF^b				0.0087
No	5,623 (88.05%)	2,945 (89.08%)	2,678 (86.95%)
Yes	763 (11.95%)	361 (10.92%)	402 (13.05%)
Diabetes^b				< 0.0001
No	5,068 (79.36%)	2,549 (77.1%)	2,519 (81.79%)
Yes	1,318 (20.64%)	757 (22.9%)	561 (18.21%)
HTN^b				0.0343
No	3,637 (56.95%)	1,841 (55.69%)	1,796 (58.31%)
Yes	2,749 (43.05%)	1,465 (44.31%)	1,284 (41.69%)
Sex^b				< 0.0001
Female	2,729 (42.73%)	1,180 (35.69%)	1,549 (50.29%)
Male	3,657 (57.27%)	2,126 (64.31%)	1,531 (49.71%)
Ischemic stroke^b				0.0124
No	6,039 (94.57%)	3,149 (95.25%)	2,890 (93.83%)
Yes	347 (5.43%)	157 (4.75%)	190 (6.17%)
Vascular disease^b				0.0122
No	5,551 (86.92%)	2,840 (85.9%)	2,711 (88.02%)
Yes	835 (13.08%)	466 (14.1%)	369 (11.98%)

↓ Table 1. Demographic and Clinical Characteristics

Overall (n = 6,386)

Age 50–75 (n = 3,306)

Age 76–89 (n = 3,080)

P value

^aData are presented as median (Q1–Q3). ^bData are presented as n (%). GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; HFrEF: heart failure with reduced ejection fraction; HFpEF: heart failure with preserved ejection fraction; HTN: hypertension.

Age^a

75 (67–81)

67 (62–72)

81 (79–85)

CHA₂DS₂-VASc^a score

3 (2.0–4.0)

2 (1.0–3.0)

4 (3.0–4.0)

< 0.0001

GFR^a

55 (34–76)

61 (37–82)

50 (32–68)

< 0.0001

ORBIT score^a

2 (1.0–3.0)

1 (0–2)

2 (1.0–3.0)

< 0.0001

Active bleeding^b

0.0013

5,770 (90.35%)

3,025 (91.5%)

2,745 (89.12%)

Yes

616 (9.65%)

281 (8.5%)

335 (10.88%)

Antiplatelet use^b

0.0023

5,309 (83.13%)

2,794 (84.51%)

2,515 (81.66%)

Yes

1,077 (16.87%)

512 (15.49%)

565 (18.34%)

History of bleeding^b

0.556

4,447 (69.64%)

2,313 (69.96%)

2,134 (69.29%)

Yes

1,939 (30.36%)

993 (30.04%)

946 (30.71%)

HFrEF or HFpEF^b

0.0087

5,623 (88.05%)

2,945 (89.08%)

2,678 (86.95%)

Yes

763 (11.95%)

361 (10.92%)

402 (13.05%)

Diabetes^b

< 0.0001

5,068 (79.36%)

2,549 (77.1%)

2,519 (81.79%)

Yes

1,318 (20.64%)

757 (22.9%)

561 (18.21%)

HTN^b

0.0343

3,637 (56.95%)

1,841 (55.69%)

1,796 (58.31%)

Yes

2,749 (43.05%)

1,465 (44.31%)

1,284 (41.69%)

Sex^b

< 0.0001

Female

2,729 (42.73%)

1,180 (35.69%)

1,549 (50.29%)

Male

3,657 (57.27%)

2,126 (64.31%)

1,531 (49.71%)

Ischemic stroke^b

0.0124

6,039 (94.57%)

3,149 (95.25%)

2,890 (93.83%)

Yes

347 (5.43%)

157 (4.75%)

190 (6.17%)

Vascular disease^b

0.0122

5,551 (86.92%)

2,840 (85.9%)

2,711 (88.02%)

Yes

835 (13.08%)

466 (14.1%)

369 (11.98%)

↓ **Table 2.** Prevalence of Underutilization and Appropriateness by Age Groups
	Overall (n = 6,386)	Age 50–75 (n = 3,306)	Age 76–89 (n = 3,080)	P value
Underutilization				< 0.0001
Yes	831 (13.01%)	183 (5.54%)	648 (21.04%)
No	5,555 (86.99%)	3,123 (94.46%)	2,432 (78.96%)
Appropriateness				< 0.0001
Yes	1,110 (17.38%)	410 (12.40%)	700 (22.73%)
No	5,276 (82.62%)	2,896 (87.60%)	2,380 (77.27%)

↓ Table 2. Prevalence of Underutilization and Appropriateness by Age Groups

Overall (n = 6,386)

Age 50–75 (n = 3,306)

Age 76–89 (n = 3,080)

P value

Underutilization

< 0.0001

Yes

831 (13.01%)

183 (5.54%)

648 (21.04%)

5,555 (86.99%)

3,123 (94.46%)

2,432 (78.96%)

Appropriateness

< 0.0001

Yes

1,110 (17.38%)

410 (12.40%)

700 (22.73%)

5,276 (82.62%)

2,896 (87.60%)

2,380 (77.27%)

↓ **Table 3.** Univariate Analysis for the Association of the Appropriateness With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding
Variables	Odds ratio (95% CI)	P value
GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.
CHA₂DS₂-VASc	1.659 (1.581–1.741)	< 0.0001
ORBIT score	0.665 (0.629–0.703)	< 0.0001
GFR	1.008 (1.005–1.010)	< 0.0001
Active bleeding (reference: yes)	15.902 (8.208–30.809)	< 0.0001
Bleeding (reference: yes)	12.943 (9.584–17.479)	< 0.0001

↓ Table 3. Univariate Analysis for the Association of the Appropriateness With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding

Variables

Odds ratio (95% CI)

P value

GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.

CHA₂DS₂-VASc

1.659 (1.581–1.741)

< 0.0001

ORBIT score

0.665 (0.629–0.703)

< 0.0001

GFR

1.008 (1.005–1.010)

< 0.0001

Active bleeding (reference: yes)

15.902 (8.208–30.809)

< 0.0001

Bleeding (reference: yes)

12.943 (9.584–17.479)

< 0.0001

↓ **Table 4.** Multivariate Analysis for the Association of the Appropriateness With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding
Variables	Odds ratio (95% CI)	P value
GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.
CHA₂DS₂-VASc	1.978 (1.854–2.110)	< 0.0001
ORBIT score	0.723 (0.636–0.821)	< 0.0001
GFR	1.003 (0.999–1.007)	0.1806
Active bleeding (reference: yes)	1.406 (0.620–3.190)	0.4144
Bleeding (reference: yes)	10.582 (6.467–17.315)	< 0.0001

↓ Table 4. Multivariate Analysis for the Association of the Appropriateness With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding

Variables

Odds ratio (95% CI)

P value

GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.

CHA₂DS₂-VASc

1.978 (1.854–2.110)

< 0.0001

ORBIT score

0.723 (0.636–0.821)

< 0.0001

GFR

1.003 (0.999–1.007)

0.1806

Active bleeding (reference: yes)

1.406 (0.620–3.190)

0.4144

Bleeding (reference: yes)

10.582 (6.467–17.315)

< 0.0001

↓ **Table 5.** Univariate for the Association of the Underutilization With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding
Variables	Odds ratio (95% CI)	P value
GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.
CHA₂DS₂-VASc	1.848 (1.749–1.954)	< 0.0001
ORBIT score	4.743 (4.309–5.221)	< 0.0001
GFR	0.985 (0.982–0.988)	< 0.0001
Active bleeding (reference: yes)	6.480 (5.403–7.773)	< 0.0001
Bleeding (reference: yes)	20.431 (16.690–25.011)	< 0.0001

↓ Table 5. Univariate for the Association of the Underutilization With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding

Variables

Odds ratio (95% CI)

P value

GFR: glomerular filtration fraction; ORBIT: Outcomes Registry for Better Informed Treatment; CI: confidence interval.

CHA₂DS₂-VASc

1.848 (1.749–1.954)

< 0.0001

ORBIT score

4.743 (4.309–5.221)

< 0.0001

GFR

0.985 (0.982–0.988)

< 0.0001

Active bleeding (reference: yes)

6.480 (5.403–7.773)

< 0.0001

Bleeding (reference: yes)

20.431 (16.690–25.011)

< 0.0001

↓ **Table 6.** Multivariate Analyses for the Association of the Underutilization With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding
Variables	Odds ratio (95% CI)	P value
GFR: glomerular filtration fraction; CI: confidence interval; ORBIT: Outcomes Registry for Better Informed Treatment.
CHA₂DS₂-VASc	1.993 (1.837–2.164)	< 0.0001
ORBIT score	3.736 (3.163–4.413)	< 0.0001
GFR	1.006 (1.001–1.010)	0.0185
Active bleeding (reference: yes)	1.300 (1.012–1.670)	0.0400
Bleeding (reference: yes)	2.402 (1.666–3.462)	< 0.0001

↓ Table 6. Multivariate Analyses for the Association of the Underutilization With CHA₂DS₂-VASc, ORBIT Score, GFR, Active Bleeding and Bleeding

Variables

Odds ratio (95% CI)

P value

GFR: glomerular filtration fraction; CI: confidence interval; ORBIT: Outcomes Registry for Better Informed Treatment.

CHA₂DS₂-VASc

1.993 (1.837–2.164)

< 0.0001

ORBIT score

3.736 (3.163–4.413)

< 0.0001

GFR

1.006 (1.001–1.010)

0.0185

Active bleeding (reference: yes)

1.300 (1.012–1.670)

0.0400

Bleeding (reference: yes)

2.402 (1.666–3.462)

< 0.0001

↓ **Table 7.** Prevalence of Appropriateness of Clinical Decisions Against Anticoagulation by Incidence of Ischemic Stroke
	Stroke = yes (n = 347)	Stroke = no (n = 6,039)	P value
Appropriateness			0.6957
Yes	63 (18.16%)	1,047 (17.34%)
No	284 (81.84%)	4,992 (82.66%)

↓ Table 7. Prevalence of Appropriateness of Clinical Decisions Against Anticoagulation by Incidence of Ischemic Stroke

Stroke = yes (n = 347)

Stroke = no (n = 6,039)

P value

Appropriateness

0.6957

Yes

63 (18.16%)

1,047 (17.34%)

284 (81.84%)

4,992 (82.66%)