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Oral anticoagulants in older adults with atrial fibrillation

Gwen M Bernacki1, Richard C Becker

  • 1Division of Cardiology, Duke University Medical Center, Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC, 27705, USA, gwen.bernacki@dm.duke.edu.

Journal of Thrombosis and Thrombolysis
|January 24, 2013
PubMed

Insights

Older adults with atrial fibrillation (AF) require safe and effective oral anticoagulant therapies. This review covers key considerations for using these treatments in the elderly, including drug interactions and comorbidities.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Atrial fibrillation (AF) is the most prevalent adult arrhythmia.
  • AF significantly increases risks of stroke, heart failure, and cardiovascular death.
  • Age-related increases in AF incidence necessitate improved therapeutic strategies.

Purpose of the Study:

  • To review oral anticoagulant use in older adults with AF.
  • To highlight practical considerations for managing anticoagulation in elderly patients.
  • To address challenges in complex healthcare and payer environments.

Main Methods:

  • Literature review of oral anticoagulants in elderly AF patients.
  • Focus on drug metabolism and drug-drug interactions.
  • Analysis of comorbidity and cost factors in treatment selection.

Main Results:

  • Older adults present unique challenges for oral anticoagulation.
  • Drug metabolism and interactions require careful management.
  • Comorbidities and cost significantly influence therapy choices.

Conclusions:

  • Optimizing oral anticoagulation in elderly AF patients requires a multifaceted approach.
  • Consideration of pharmacokinetics, pharmacodynamics, and patient-specific factors is crucial.
  • Effective management strategies are essential for reducing AF-related adverse events in this population.

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