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# Anticoagulation discontinuation in long-term care residents with atrial fibrillation
- URL: https://www.coios.me/anticoagulation-discontinuation-in-long-term-care-residents/
- Published: 2026-10-31T11:13:30.000Z
- Updated: 2026-11-01T07:06:41.000Z
- Description: In 15,426 US long-term care residents with atrial fibrillation, stopping anticoagulation was not linked to more strokes or bleeds.
- Author: Daniel Ryan
- Tags: Health today, Heart and stroke, United States, #peer-reviewed, #new, #item, #source-2026-10, #score-62

This study asked whether stopping anticoagulation on entering long-term care alters stroke and bleeding risk in atrial fibrillation. It used 2020–2021 US Medicare claims for 15,426 residents, mean age 82.6 years, who entered care on anticoagulation. A target trial emulation cloned residents into discontinuation and continuation arms, with inverse probability of censoring weighting. Stroke risk was similar for discontinuers (subdistribution HR 1.07; 95% CI 0.93–1.23), as was bleeding risk (1.02; 0.92–1.13). In the weighted analysis, the mortality hazard was higher for discontinuers (HR 1.27; 95% CI 1.23–1.31). The data are observational claims analysed by emulation, and discontinuers had shorter mean follow-up (128.9 vs 279.6 days).

*Why it is interesting: Anticoagulation prevents stroke in atrial fibrillation, but its risks lead some to consider stopping at long-term care entry. Here, stopping was not linked to higher stroke or bleeding risk, but mortality hazard was higher among stoppers.*

Source

[JAMA Network Open, 26 October 2026](https://doi.org/10.1001/jamanetworkopen.2026.40964?ref=coios.me)

Paper

Stroke and Bleeding Risk in Long-Term Care Residents With Atrial Fibrillation Who Discontinue Anticoagulation

Authors

Kapoor A, Chen Z, Patel J, Ye Z, Lin H, Barnes G et al.

DOI

10.1001/jamanetworkopen.2026.40964

Type

Peer-reviewed article

Design

Target trial emulation with clone-censor-weighting, Medicare claims 2020-2021, 15,426 US long-term care residents with atrial fibrillation

Verdict

New finding

Driver

[Heart and stroke](https://www.coios.me/d-cardiovascular/)

Free full text

[Free to read at the publisher](https://doi.org/10.1001/jamanetworkopen.2026.40964?ref=coios.me)