Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach

Background: Atrial fibrillation (AF) in the elderly is a complex condition. It has a direct impact on the underuse of antithrombotic therapy reported in this population. Discussion: All patients aged >= 75 years with AF have an individual yearly risk of stroke > 4 %. However, the risk of hemor...

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Autores: Suárez Fernández, Carmen, Formiga Pérez, Francesc, Camafort Blanco, Miquel, Cepeda Rodrigo, José María, Díez Manglano, Jesús, Pose Reino, Antonio, Tiberio, Gregorio, Mostaza, José María, Grupo de trabajo de Riesgo vascular de la SEMI
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2015
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/126924
Acesso em linha:https://hdl.handle.net/2445/126924
Access Level:acceso abierto
Palavra-chave:Anticoagulants (Medicina)
Fibril·lació auricular
Anticoagulants (Medicine)
Atrial fibrillation
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spelling Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approachSuárez Fernández, CarmenFormiga Pérez, FrancescCamafort Blanco, MiquelCepeda Rodrigo, José MaríaDíez Manglano, JesúsPose Reino, AntonioTiberio, GregorioMostaza, José MaríaGrupo de trabajo de Riesgo vascular de la SEMIAnticoagulants (Medicina)Fibril·lació auricularAnticoagulants (Medicine)Atrial fibrillationBackground: Atrial fibrillation (AF) in the elderly is a complex condition. It has a direct impact on the underuse of antithrombotic therapy reported in this population. Discussion: All patients aged >= 75 years with AF have an individual yearly risk of stroke > 4 %. However, the risk of hemorrhage is also increased. Moreover, in this population it is common the presence of other comorbidities, cognitive disorders, risk of falls and polymedication. This may lead to an underuse of anticoagulant therapy. Direct oral anticoagulants (DOACs) are at least as effective as conventional therapy, but with lesser risk of intracranial hemorrhage. The simplification of treatment with these drugs may be an advantage in patients with cognitive impairment. The great majority of elderly patients with AF should receive anticoagulant therapy, unless an unequivocal contraindication. DOACs may be the drugs of choice in many elderly patients with AF. Summary: In this manuscript, the available evidence about the management of anticoagulation in elderly patients with AF is reviewed. In addition, specific practical recommendations about different controversial issues (i.e. patients with anemia, thrombocytopenia, risk of gastrointestinal bleeding, renal dysfunction, cognitive impairment, risk of falls, polymedication, frailty, etc.) are provided.BioMed Central2018201820152018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/126924Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1186/s12872-015-0137-7BMC Cardiovascular Disorders, 2015, vol. 15, num. 143https://doi.org/10.1186/s12872-015-0137-7cc by (c) Suárez Fernández et al., 2015http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1269242026-05-29T05:05:01Z
dc.title.none.fl_str_mv Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
title Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
spellingShingle Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
Suárez Fernández, Carmen
Anticoagulants (Medicina)
Fibril·lació auricular
Anticoagulants (Medicine)
Atrial fibrillation
title_short Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
title_full Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
title_fullStr Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
title_full_unstemmed Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
title_sort Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach
dc.creator.none.fl_str_mv Suárez Fernández, Carmen
Formiga Pérez, Francesc
Camafort Blanco, Miquel
Cepeda Rodrigo, José María
Díez Manglano, Jesús
Pose Reino, Antonio
Tiberio, Gregorio
Mostaza, José María
Grupo de trabajo de Riesgo vascular de la SEMI
author Suárez Fernández, Carmen
author_facet Suárez Fernández, Carmen
Formiga Pérez, Francesc
Camafort Blanco, Miquel
Cepeda Rodrigo, José María
Díez Manglano, Jesús
Pose Reino, Antonio
Tiberio, Gregorio
Mostaza, José María
Grupo de trabajo de Riesgo vascular de la SEMI
author_role author
author2 Formiga Pérez, Francesc
Camafort Blanco, Miquel
Cepeda Rodrigo, José María
Díez Manglano, Jesús
Pose Reino, Antonio
Tiberio, Gregorio
Mostaza, José María
Grupo de trabajo de Riesgo vascular de la SEMI
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anticoagulants (Medicina)
Fibril·lació auricular
Anticoagulants (Medicine)
Atrial fibrillation
topic Anticoagulants (Medicina)
Fibril·lació auricular
Anticoagulants (Medicine)
Atrial fibrillation
description Background: Atrial fibrillation (AF) in the elderly is a complex condition. It has a direct impact on the underuse of antithrombotic therapy reported in this population. Discussion: All patients aged >= 75 years with AF have an individual yearly risk of stroke > 4 %. However, the risk of hemorrhage is also increased. Moreover, in this population it is common the presence of other comorbidities, cognitive disorders, risk of falls and polymedication. This may lead to an underuse of anticoagulant therapy. Direct oral anticoagulants (DOACs) are at least as effective as conventional therapy, but with lesser risk of intracranial hemorrhage. The simplification of treatment with these drugs may be an advantage in patients with cognitive impairment. The great majority of elderly patients with AF should receive anticoagulant therapy, unless an unequivocal contraindication. DOACs may be the drugs of choice in many elderly patients with AF. Summary: In this manuscript, the available evidence about the management of anticoagulation in elderly patients with AF is reviewed. In addition, specific practical recommendations about different controversial issues (i.e. patients with anemia, thrombocytopenia, risk of gastrointestinal bleeding, renal dysfunction, cognitive impairment, risk of falls, polymedication, frailty, etc.) are provided.
publishDate 2015
dc.date.none.fl_str_mv 2015
2018
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/126924
url https://hdl.handle.net/2445/126924
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1186/s12872-015-0137-7
BMC Cardiovascular Disorders, 2015, vol. 15, num. 143
https://doi.org/10.1186/s12872-015-0137-7
dc.rights.none.fl_str_mv cc by (c) Suárez Fernández et al., 2015
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Suárez Fernández et al., 2015
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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