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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Published on: February 28, 2012

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Direct Oral Anticoagulants for Very Elderly People With Atrial Fibrillation: Efficacy and Safe Enough?

Samantha Pasca1, Ugo Venturelli2, Antonella Bertone2

  • 1Center for Hemorrhagic and Thrombotic Diseases, University Hospital of Udine, Udine, Italy sampasca@alice.it.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|December 2, 2015
PubMed

Insights

Direct oral anticoagulants (DOACs) are effective and safe for elderly atrial fibrillation patients. These anticoagulants offer a good alternative to older therapies, showing high compliance and efficacy in real-world use.

Area of Science:

  • Cardiology
  • Pharmacology
  • Geriatrics

Background:

  • Four direct oral anticoagulants (DOACs) are approved for atrial fibrillation (AF) treatment.
  • Clinical trials demonstrate DOAC efficacy and safety, but real-world data in elderly populations is limited.

Purpose of the Study:

  • To assess the effectiveness and safety of DOACs in patients aged 75 years and older with AF.
  • To evaluate the impact of switching from previous anticoagulation treatments to DOACs in this demographic.

Main Methods:

  • A prospective study included consecutive patients aged 75 years and older with AF who were switched to DOACs.
  • Follow-up assessments were conducted at 3, 6, and 12 months via phone and in-person visits.

Main Results:

  • 143 elderly patients (mean age 81 years) were switched to DOACs, with a median follow-up of 9.6 months.
  • Four minor bleedings and one nonmajor bleeding event occurred, managed by dose adjustment or temporary cessation.
  • Two strokes were reported in patients on dabigatran 110 mg, with no serious sequelae; 2.8% experienced adverse effects like nausea.
  • Four deaths occurred, unrelated to anticoagulation therapy.

Conclusions:

  • DOACs represent a viable and effective alternative to traditional anticoagulants for elderly patients with AF.
  • High patient compliance and a favorable safety/efficacy profile position DOACs as a preferred option for long-term anticoagulation in older adults.
Abstract

Keywords:
anticoagulantsbleedingcardiologystroke

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