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Safety outcomes of direct oral anticoagulants in older adults with atrial fibrillation: a systematic review and meta-analysis of (subgroup analyses from) randomized controlled trials
AbstractBalancing stroke prevention and risk of bleeding in patients with atrial fibrillation (AF) is challenging. Direct oral anticoagulants (DOACs) are by now considered standard of care for treating patients with AF in international guidelines. Our objective was to assess the safety of long-term intake of DOACs in older adults with AF. We included RCTs in elderly ( ≥ 65 years) patients with AF. A systematic search in MEDLINE and EMBASE was performed on 19 April 2022. For determination of risk of bias, the RoB 2 tool was applied. We pooled outcomes using random-effects meta-analyses. The quality of evidence was as...
Source: AGE - June 1, 2023 Category: Geriatrics Source Type: research

Influence of atrial fibrillation subtypes on anticoagulant therapy in a high-risk older population: the FAI project
CONCLUSIONS: In a population-based survey, AF pattern was an independent predictor of OAC treatment. Paroxysmal AF is still perceived as carrying a lower risk of vascular events.PMID:35543807 | DOI:10.1007/s40520-022-02140-w
Source: Aging Clinical and Experimental Research - May 11, 2022 Category: Geriatrics Authors: Antonio Di Carlo Fabio Mori Domenico Consoli Leonardo Bellino Augusto Zaninelli Marzia Baldereschi Maria Grazia D'Alfonso Chiara Gradia Alessandro Cattarinussi Bruno Sgherzi Giovanni Pracucci Benedetta Piccardi Bianca Maria Polizzi Domenico Inzitari Natio Source Type: research

Direct Oral Anticoagulants and Non-valvular Atrial Fibrillation: Compliance with Dose Level Guidelines in Patients Aged 80  Years and Over
ConclusionsAmong patients with non-valvular atrial fibrillation aged 80 years and over, about 40% of DOAC prescriptions feature inappropriate dose levels. It might be possible to reduce inappropriate dosing by raising awareness among hospital-based and private-practice prescribers, providing prescription support tools for DOACs, and performing medication reconciliations and reviews at hospital and in private practice.
Source: Drugs and Aging - September 6, 2021 Category: Geriatrics Source Type: research

Relationship between multimorbidity and outcomes in atrial fibrillation
CONCLUSIONS: In a nationwide contemporary cohort of AF anticoagulated patients, multimorbidity was inversely associated with good anticoagulation control. A progressively higher risk for major bleeding, CV death and all-cause death was found across CCI quartiles.PMID:34303775 | DOI:10.1016/j.exger.2021.111482
Source: Experimental Gerontology - July 25, 2021 Category: Geriatrics Authors: Marco Proietti Mar ía Asunción Esteve-Pastor Jos é Miguel Rivera-Caravaca Vanessa Rold án Inmaculada Rold án Rabadán Javier Mu ñiz Ángel Cequier Vicente Bertomeu-Mart ínez Lina Badim ón Manuel Anguita Gregory Y H Lip Francisco Mar ín FANTASIIA Source Type: research

87 Evolution of Atrial Fibrillation
ConclusionThere has been a significant increase in primary prevention practices for AF and this is reflected in the number of stroke patients presenting with known AF on a NOAC, however more needs to be done as there are still patients who have AF that are not being anticoagulated in the community.
Source: Age and Ageing - September 16, 2019 Category: Geriatrics Source Type: research

Introduction of Non-Vitamin K Antagonist Anticoagulants Strongly Increased the Rate of Anticoagulation in Hospitalized Geriatric Patients with Atrial Fibrillation
ConclusionThe introduction of non-vitamin K antagonist oral anticoagulants and an increased awareness of their benefits led to an increased use of anticoagulation from 52.8% (2011) to 87.7% (2015) in geriatric patients with atrial fibrillation and flutter at our institution.
Source: Drugs and Aging - August 1, 2018 Category: Geriatrics Source Type: research

Effectiveness and safety of oral anticoagulants in older patients with atrial fibrillation: a systematic review and meta-regression analysis
Conclusionswarfarin use was superior to warfarin non-use, aspirin and no antithrombotic therapy in reducing the risk of stroke/TE in older AF patients, but with a possible increase in major bleeding. NOACs were superior to warfarin for stroke/TE prevention, with reduced risk of major bleeding.
Source: Age and Ageing - September 8, 2017 Category: Geriatrics Source Type: research

Health status, geriatric syndromes and prescription of oral anticoagulant therapy in elderly medical inpatients with atrial fibrillation
ConclusionsWe showed a high prevalence of atrial fibrillation among older medical inpatients, who have a poor health status and a high prevalence of geriatric syndromes. Vitamin K antagonists were prescribed in less than half of the patients; underuse was mainly accounted for by a high prevalence of comorbidities/contraindications, poor health status and limited functional autonomy. Geriatr Gerontol Int 2016; ●●: ●●–●●.
Source: Geriatrics and Gerontology International - January 28, 2016 Category: Geriatrics Authors: Mario Bo, Irene Sciarrillo, Guido Maggiani, Yolanda Falcone, Marina Iacovino, Enrica Grisoglio, Gianfranco Fonte, Simon Grosjean, Fiorenzo Gaita Tags: Original Article: Epidemiology, Clinical Practice and Health Source Type: research

Vitamin K Antagonists and Cognitive Impairment: Results From a Cross-Sectional Pilot Study Among Geriatric Patients
Conclusions. We found more frequent cognitive impairment associated with the use of VKAs, specifically fluindione, among geriatric patients.
Source: Journals of Gerontology Series A: Biological Sciences and Medical Sciences - December 24, 2014 Category: Geriatrics Authors: Annweiler, C., Ferland, G., Barberger-Gateau, P., Brangier, A., Rolland, Y., Beauchet, O. Tags: Brief Report Source Type: research