Grant: Operating Grant - Priority Announcement: Prospective Active Surveillance

Atrial fibrillation is a heart condition that increases the chance of stroke in elderly individuals, and this can be prevented through anticoagulation, or blood-thinning. Too much blood-thinning, however, can lead to bleeding and death. Recently, two new drugs were approved as recommended therapy for blood-thinning in people living with atrial fibrillation based on results of studies that showed their superiority over an older drug, warfarin. However, there have been recent reports of severe bleeding among people taking these new blood-thinners, complicated by the fact that there is no approved antidote to reverse the effect of these drugs in hospital once bleeding begins. The purpose of this study is to find out 1) what are the current types of treatment and their associated medical costs for elderly patients who present to four major hospitals in Ontario with bleeds from new blood-thinners and warfarin; and 2) if the outcomes after treatment are different between these two groups of patients. Health records departments at our participating hospitals and our research unit have unique databases that capture information about diagnosis, treatment, cost and outcomes of hospital encounters. We will also review the charts of individuals who came to hospital with blood-thinner-related bleeds to see which medications they were on when they came in. By looking at costs and outcomes of treating the elderly suffering from new blood-thinner complications using real-world patient data, we hope to provide information about current Canadian practices and provide preliminary information for further research, all aimed at improving the health and well-being of atrial fibrillation patients undergoing blood-thinner treatment.