Direct oral anticoagulants in non-valvular atrial fibrillation in elderly: for a treatment adapted to patient profile

Geriatr Psychol Neuropsychiatr Vieil. 2018 Sep 1;16(3):229-240. doi: 10.1684/pnv.2018.0746.

Abstract

Atrial fibrillation is the most frequent rhythm disorder in elderly patients. Moreover, the risk of stroke and the bleeding risk under anticoagulant treatment are the highest in this population. Vitamin K antagonists were until now the reference treatment of the anticoagulant treatment and they demonstrated a net benefit, including in elderly patients. The availability of the new oral anticoagulants, which do not require biological monitoring, simplified the anticoagulant treatment. However, data for the use of these molecules in elderly population remain limited. The benefit-risk ratio must not be assessed for this therapeutic class taken as a whole but for each molecule and according to the patient profile.

Keywords: atrial fibrillation; direct oral anticoagulants; elderly population.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Geriatric Assessment*
  • Humans
  • Precision Medicine

Substances

  • Anticoagulants