Evaluation of the impact of NOAC underdosing and exploration of bleeding risk factors in elderly patients with atrial fibrillation: artificial intelligence-based approach

Underdosing NOAC was associated with a reduced bleeding risk but at the cost of a markedly increased thrombosis risk. Guideline-concordant dosing was also associated with higher bleeding risk in the multivariable model. Overall, the results do not support systematic underdosing of NOACs in elderly patients. These findings were shared with local prescribers to reinforce appropriate dosing practices and to improve follow-up for patients identified as being at increased bleeding risk.