Key result
Stroke risk in AF increases from 1.5% in the 5th decade to 23.5% in patients >80; novel anticoagulants are at least as effective as warfarin for stroke risk reduction without needing INR monitoring.
Why the study?
Do novel anticoagulant agents (dabigatran, rivaroxaban, apixaban) improve stroke risk reduction and safety compared to warfarin in older adults with atrial fibrillation?
Do novel anticoagulant agents (dabigatran, rivaroxaban, apixaban) improve stroke risk reduction and safety compared to warfarin in older adults with atrial fibrillation?
Novel oral anticoagulants offer an effective alternative to warfarin for stroke prevention in older adults with atrial fibrillation, though factors like cost, adherence, and lack of reversal agents must be considered.
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias seen in clinical practice. Stroke risk in patients diagnosed with AF increases from 1.5% in the fifth decade of life to 23.5% in patients older than 80, emphasizing the need for effective and appropriate therapies. Over the past 50 years, vitamin K antagonists-namely warfarin (Coumadin(®))-have been the mainstay for stroke prevention. The introduction of dabigatran (Pradaxa(®)), rivaroxaban (Xarelto(®)), and apixaban (Eliquis(®)) has caused both patients and providers to question whether better alternatives to warfarin therapy exist. These agents have shown to be at least as effective as warfarin in stroke risk reduction with no need for international normalized ratio monitoring. This review will examine these newer anticoagulant agents' safety and efficacy and provide clinical considerations for treating older adults with AF. Clinicians with patients unable to tolerate warfarin or with difficulty managing therapy will need to consider patient characteristics, cost, adherence, lack of a reversal agent, and long-term efficacy before prescribing these agents.
No takes yet. Share an insight, caveat, or question.
Ogbonna et al. (2013) conducted a review in Atrial fibrillation. Novel anticoagulant agents (dabigatran, rivaroxaban, apixaban) vs. Warfarin was evaluated on Stroke risk reduction. Stroke risk in AF increases from 1.5% in the 5th decade to 23.5% in patients >80; novel anticoagulants are at least as effective as warfarin for stroke risk reduction without needing INR monitoring.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: