Key result
Direct oral anticoagulants are recommended for stroke prevention in elderly patients with atrial fibrillation, and specific antidotes like idarucizumab and andexanet alfa provide safe reversal of their effects during critical bleeding.
Why the study?
An increasing elderly population has led to a higher prevalence of atrial fibrillation, necessitating discussion on the feasibility and parameters of prescribing anticoagulants to prevent ischemic stroke and systemic thromboembolism.
Direct oral anticoagulants offer a favorable efficacy and safety profile compared to warfarin for stroke prevention in elderly patients with atrial fibrillation, supported by the availability of specific reversal agents for bleeding emergencies.
Supports DOAC use with antidotes in elderly AF; leaves open need for dedicated prospective trials.
The increase in the proportion of elderly people observed in the population is accompanied by an increase in the prevalence of age-related diseases, including atrial fibrillation. In the treatment of such patients it is necessary to discuss the feasibility of prescribing anticoagulants to prevent ischemic stroke and systemic thromboembolism. The article presents scales that are used to assess the risk of thromboembolic complications and the risk of bleeding. The parameters that should be taken into account when prescribing oral anticoagulants to elderly patients are determined, the principles of bleeding risk management are given. The listed risk factors for bleeding, which are modified, potentially modified and not modified. Attention is paid to the description of specific antidotes to oral anticoagulants, the use of which has expanded in recent years, so many health professionals should know the main pharmacological effects of these drugs, be able to assess their anticoagulant effect in critical conditions and optimally cancel if necessary.
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Бiловол et al. (2021) conducted a review in Atrial fibrillation. Direct oral anticoagulants and specific antidotes was evaluated. Direct oral anticoagulants are recommended for stroke prevention in elderly patients with atrial fibrillation, and specific antidotes like idarucizumab and andexanet alfa provide safe reversal of their effects during critical bleeding.
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