Frailty and outcomes in octogenarians with atrial fibrillation treated with edoxaban: ESCAPE study

Abstract Background Frailty is associated with significant morbidity and mortality among elderly adults. Whether frailty predicts adverse outcomes in patients treated oral anticoagulants for stroke prevention atrial fibrillation remains uncertain. Purpose To examine the impact of clinical non-valvular edoxaban. Methods This an observational prospective single centre cohort study enrolling consecutive naïve to anticoagulation age ≥80 years starting edoxaban followed up 2 years. At baseline, all were evaluated frailty, comorbidities, medications, bleeding risk factors. was assessed using Survey Health Ageing Retirement Europe Index (SHARE-FI) tool, a validated measure centred on health resource utilisation, stratified into non-frail, pre-frail frail. The cumulative incidence stroke/systemic embolism, major bleeding, clinically relevant non-major (CRNMB), individual components part composite outcome. Results Among 160 who received fibrillation, 34% frail, 20% pre-frail, 46% non-frail. mean 85±4 58% female. CHA2DS2VASc score 4±1. Mean Cockroft-Gault creatinine clearance (CrCl) 52±17 mL/min, 30mg administered 59% as per indications (weight ≤60 kg and/or, CrCl 15–50 ml/min). follow extended 681±289 days. Primary endpoint occurred 46 (28.7%; annualised rate 15.4%patient-years): 19 events 9 18 frail (p=0.6). Stroke/systemic embolism 2.2%, 5.0%, CRNM 10.0% patients. not predictor outcome (non-frail 5.4% vs 0% 1.9%, p=0.27; non-frail 9.4% p=0.29; 13.5% 3.1% 9.3%, p=0.25; CRNMB, respectively). Cumulative (Figure) did differ versus rest pre-frail) (p=0.521). Conclusions status Anticoagulation feasible octogenarians even if Funding Acknowledgement Type funding sources: None.