Open AccessOptimal anticoagulation in elderly patients with atrial fibrillation: Which drug at which dose?
Author(s) -
JoNan Liao,
YiHsin Chan,
Ling Kuo,
Chuan-Tsai Tsai,
Su-Shen Lim,
TzeFan Chao
Publication year - 2022
Publication title -
kardiologia polska
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.527
H-Index - 34
eISSN - 1897-4279
pISSN - 0022-9032
DOI - 10.33963/kp.a2022.0046
Subject(s) - medicine , atrial fibrillation , warfarin , stroke (engine) , randomized controlled trial , vitamin k antagonist , adverse effect , intensive care medicine , clinical trial , cohort , drug , cardiology , pharmacology , mechanical engineering , engineering
Aging is an important risk factor for adverse events in elderly patients with atrial fibrillation (AF) and complicates the management of anticoagulation. Underuse of oral anticoagulants (OACs) is common in elderly patients because of comorbidities, the altered physiological function of multiple organs, frailty, risk of falls, and the lack of randomized controlled trials (RCTs) specifically for elderly patients. Nevertheless, current data still support OACs use for reducing ischemic stroke with positive net clinical benefits. Sub-analyses of RCTs and real-world cohort studies showed that non-vitamin K antagonist OACs (NOACs) would be more favorable choices compared to warfarin for stroke prevention in the elderly. This review will discuss important data on stroke prevention and the use of NOACs in elderly AF patients.