Anticoagulation in Octogenarians with Atrial Fibrillation: Balancing Mortality Benefits and Bleeding Risks

In patients aged 80 years and older with atrial fibrillation (AF), continued anticoagulation is associated with a 25% reduction in all-cause mortality at one year compared to no anticoagulation.
Initiation or discontinuation of anticoagulation in this population is linked to higher mortality compared with continued anticoagulation.
Gastrointestinal bleeding risk increases with anticoagulation therapy, but rates of intracranial hemorrhage remain low and similar across anticoagulation groups.
Five-year mortality rates converge, suggesting time-dependent survival benefit and highlighting complexities in long-term management decisions.

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