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In the context of a globally aging population, modern cardiology is increasingly faced with the need to manage chronic diseases such as atrial fibrillation (AF) in elderly and senile patients. Along with the increasing incidence of AF in older age groups, so-called geriatric syndromes—multifactorial clinical conditions associated with decreased physiological reserves and increased vulnerability to stressors—are becoming more prominent.
The aim of the study was to comparatively analyze hemodynamic parameters and laboratory data in elderly and senile patients with atrial fibrillation.
Materials and Methods. A retrospective analysis of hospital data was conducted among 267 patients with atrial fibrillation at City Clinical Hospital No. 3, State Budgetary Healthcare Institution of the Perm Region: Group 1 (119 patients aged 75 and older), and Group 2 (147 patients aged 60-74 years). Anthropometric assessment, hemodynamics, complete blood count, coagulation profile, and echocardiography with left ventricular ejection fraction (LVEF, %) were performed.
Results. General clinical examinations revealed differences between the elderly and senile age groups. Patients aged ≥75 years were shorter (median 160 cm, Q₁–Q₃: 155–166 cm) than elderly patients (median 167.5 cm, Q₁–Q₃: 160–174 cm), p < 0.001. Body weight was significantly lower in the senile group (median 72 kg, Q₁–Q₃: 61–80 kg) compared to the elderly group (median 80 kg, Q₁–Q₃: 70–95 kg), p < 0.001. The body mass index in group 1 (27.2 kg/m²) was statistically significantly lower than in group 2 (29.4 kg/m²), p=0.007. Systolic blood pressure was slightly higher in the elderly group (130 mmHg versus 120 mmHg in the elderly group, p=0.571). The median LVEF was 60% in both groups, which corresponds to preserved systolic function, p=0.797. Elderly patients showed a decrease in red blood cell counts (erythrocytes, hemoglobin, hematocrit), and a significantly higher ESR level. Basic parameters of the blood coagulation system in elderly and senile patients with AF did not differ statistically; the level of soluble fibrin monomer complexes increased significantly in patients 75 years of age and older. Conclusions: the clinical profile of a patient with AF in the elderly (≥75 years), compared to an elderly patient, is characterized by lower anthropometric parameters, signs of anemia and increased inflammation, and laboratory signs of increased thrombotic susceptibility despite a formally normal standard coagulation profile. These characteristics must be considered when developing a comprehensive therapeutic strategy, particularly in matters of anemia correction, inflammation control, and thromboembolism risk assessment.
Keywords:atrial fibrillation, elderly, old age
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