Antithrombotic Treatments for Stroke Prevention in Elderly Patients With Nonvalvular Atrial Fibrillation: Drugs and Doses

Can J Cardiol. 2016 Sep;32(9):1108-16. doi: 10.1016/j.cjca.2016.06.003. Epub 2016 Jun 14.

Abstract

Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are previous stroke and age ≥ 75 years. Canadian guidelines recommend anticoagulant therapy for patients with AF who are older than the age of 65 years, but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagulants appear to be safer, at least as efficacious, and more convenient than warfarin, and are a cost-effective alternative for elderly patients with AF. We review the evidence for the use of antithrombotic agents for stroke prevention in elderly patients (age ≥ 75 years) with nonvalvular AF.

Publication types

  • Review

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / drug therapy*
  • Cognitive Dysfunction / complications
  • Coronary Artery Disease / complications
  • Fibrinolytic Agents / therapeutic use*
  • Hemorrhage / chemically induced
  • Humans
  • Platelet Aggregation Inhibitors / therapeutic use
  • Polypharmacy
  • Renal Insufficiency / complications
  • Risk Assessment
  • Stroke / prevention & control*
  • Vitamin K / antagonists & inhibitors

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors
  • Vitamin K