Balancing the risk of stroke and bleeding in atrial fibrillation patients with a history of falls

Expert Opin Drug Saf. 2023 Oct 20. doi: 10.1080/14740338.2023.2273333. Online ahead of print.ABSTRACTINTRODUCTION: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and can lead to serious consequences such as ischemic stroke and systemic thromboembolism. The risk of thromboembolism can be reduced by anticoagulation, however many patients with high falls risk do not receive oral anticoagulation.AREAS COVERED: In this narrative literature review, performed with searches of the PubMed database, we discuss the factors predisposing AF patients to falls, ways to optimize bleeding risk with individualized assessment, and clarify the misconceptions around falls risk and anticoagulation therapy.EXPERT OPINION: In general, the advantages of stroke prevention with oral anticoagulation outweigh the risk of bleeding resulting from falls, especially with the increasing use of non-vitamin K oral anticoagulants, which are associated with fewer intracranial hemorrhages and thromboembolic complications than vitamin K anticoagulants. Most studies in this field are observation and randomized controlled studies would be beneficial.PMID:37860853 | DOI:10.1080/14740338.2023.2273333
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Authors: Source Type: research