Open AccessPrevention of stroke in elderly patients with a trial fibrillation: possibilities of Apixaban
Author(s) -
Н. М. Воробьева,
О. Н. Ткачева
Publication year - 2020
Publication title -
rossijskij žurnal geriatričeskoj mediciny
Language(s) - English
Resource type - Journals
eISSN - 2686-8709
pISSN - 2686-8636
DOI - 10.37586/2686-8636-2-2020-138-146
Subject(s) - apixaban , medicine , atrial fibrillation , randomized controlled trial , stroke (engine) , warfarin , clinical trial , intensive care medicine , observational study , embolism , rivaroxaban , mechanical engineering , engineering
In review article, we discuss the opportunity of use of one of the direct oral anticoagulants – apixaban – for prevention of stroke and/or systemic embolism in elderly patients with non-valvular a trial fibrillation. We consider results of randomized clinical trials of apixaban – ARISTOTLE and AVERROES, including the subgroups analysis in patients in the age of ≥75 years and ≥80 years – in ARISTOTLE, ≥75 years and ≥85 years – in AVERROES. These studies have shown that elderly patients had more benefit from apixaban administration than warfarin (in ARISTOTLE) or acetylsalicylic acid (in AVERROES). The results of two retrospective observational studies confirming the favorable profile of apixaban effectiveness and safety in elderly patients with a trial fibrillation in real clinical practice, and the main provisions of the consensus document FORTA, the purpose of which is to individualize treatment of elderly patients based on clinical characteristics of the patient, are also considered.