Key findings of the FRAIL-AF trial:

* Switching from vitamin K antagonist (VKA) to non-vitamin K antagonist oral anticoagulant (NOAC) therapy was associated with an increased risk of major and clinically relevant bleeding (hazard ratio [HR] 1.69, 95% CI 1.23-2.32).

* There was no difference in the risk of thromboembolic events between the two groups.

* The trial included 1,330 patients with atrial fibrillation (AF) who were 75 years of age or older and had at least two of the following frailty criteria:

* Self-reported difficulty walking 100 meters

* Weight loss of >10% in the past year

* Low physical activity

* Low grip strength

* The trial was conducted in 26 centers in the Netherlands and lasted for a median of 2.4 years.

* The main author of the trial is Linda Joosten, MD, from the University Medical Center Utrecht in the Netherlands. The trial was published in the journal Circulation on September 1, 2023.

Link to article: https://doi.org/10.1161/CIRCULATIONAHA.123.066485