Efficacy and safety of oral anticoagulant therapy in frail patients with atrial fibrillation

https://doi.org/10.4081/monaldi.2018.958

Authors

  • Giuseppe Patti | g.patti@unicampus.it Campus Bio-Medico University of Rome, Italy.
  • Ludmilla Mantione Campus Bio-Medico University of Rome, Italy.
  • Edoardo Bressi Campus Bio-Medico University of Rome, Italy.
  • Antonio Bisignani Catholic University of the Sacred Heart, Italy.

Abstract

Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile. Logical considerations and evidence-base data related to the reduced bleeding risk (also including major bleeding and intracranial bleeding) of NOACs make these drugs the anticoagulant agents of choice in frail patients; however, in this setting an individualised approach should be taken, taking into consideration the risk of thromboembolic and bleeding events, other comorbidities and patient-related factors, rather than a generalised “one drug fits all†approach.

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Published
2018-06-07
Info
Issue
Section
Cardiology - Original Articles
Keywords:
Atrial fibrillation, elderly patients, frailty, warfarin, NOACs, stroke, bleeding.
Statistics
  • Abstract views: 3316

  • PDF: 541
How to Cite
Patti, Giuseppe, Ludmilla Mantione, Edoardo Bressi, and Antonio Bisignani. 2018. “Efficacy and Safety of Oral Anticoagulant Therapy in Frail Patients With Atrial Fibrillation”. Monaldi Archives for Chest Disease 88 (2). https://doi.org/10.4081/monaldi.2018.958.