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Related Experiment Video

Updated: Jan 31, 2026

Assessment of the Anticoagulant and Anti-inflammatory Properties of Endothelial Cells Using 3D Cell Culture and Non-anticoagulated Whole Blood
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Anticoagulant therapy in the elderly.

Debora Karetová, Jan Bultas

    Vnitrni Lekarstvi
    |January 5, 2019
    PubMed
    Summary

    New Oral Direct Anticoagulants (NOACs) offer a safer alternative to warfarin for elderly patients at risk of stroke. These medications, including dabigatran, rivaroxaban, apixaban, and edoxaban, reduce bleeding risks and avoid regular lab monitoring.

    Area of Science:

    • Geriatrics
    • Pharmacology
    • Cardiology

    Background:

    • Elderly and fragile patients face elevated risks of atrial fibrillation and systemic embolism, necessitating anticoagulation.
    • These patients also exhibit increased bleeding risks due to age and comorbidities, complicating traditional anticoagulation.
    • Warfarin has been the standard, but new oral direct anticoagulants (NOACs) present a viable alternative.

    Purpose of the Study:

    • To evaluate the role and optimal use of NOACs in elderly and fragile patients.
    • To compare the safety and efficacy profiles of dabigatran, rivaroxaban, apixaban, and edoxaban in this demographic.
    • To inform individualized anticoagulation strategies for seniors, considering reduced doses where appropriate.

    Main Methods:

    • Review of pharmacological properties and registration studies of NOACs (dabigatran, rivaroxaban, apixaban, edoxaban).
    Keywords:
    anticoagulation therapy - apixaban - dabigatran - edoxaban - fragile patient - geriatrics - rivaroxaban

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  • Analysis of patient characteristics in geriatrics, including reduced body weight, renal function, and comorbidities.
  • Consideration of benefit-risk assessment in elderly patients undergoing anticoagulation therapy.

    • Main Results:

    • NOACs do not require regular laboratory monitoring, a significant advantage over warfarin.
    • NOACs are associated with a reduced risk of intracranial hemorrhage compared to traditional anticoagulants.
    • Individual NOACs possess specific properties allowing for tailored anticoagulation strategies.
    • Reduced doses of NOACs may be advantageous for a subset of elderly patients.

    Conclusions:

    • NOACs represent a safer and more convenient anticoagulation option for elderly and fragile patients.
    • Individualized treatment selection and dose adjustment are crucial for optimizing NOAC therapy in seniors.
    • Ongoing benefit-risk assessment is essential throughout the anticoagulation therapy in this vulnerable population.