Key result
Polypharmacy in older patients with atrial fibrillation is associated with increased risks of bleeding and adverse events, necessitating careful selection and monitoring of anticoagulants such as DOACs.
Why the study?
More than half of elderly atrial fibrillation patients have polypharmacy, carrying more comorbidities and higher risks of bleeding and mortality, alongside potential drug-drug interactions with anticoagulation therapy.
This review highlights the importance of carefully managing anticoagulation therapy in older AF patients with polypharmacy due to increased risks of bleeding, mortality, and drug interactions.
Answers are grounded in this paper and cite their sources.
Supports vigilant monitoring in polypharmacy; leaves open optimal DOAC strategies pending prospective trials.
高齢心房細動患者の半分以上がpolypharmacyであるという現状がある．Polypharmacy患者は，併存疾患が多く，腎機能が低下し，フレイルである．Polypharmacy患者ではとくに出血と死亡率が高くなる．抗凝固療法を行う上では，ワルファリンは薬剤相互作用が多く，DOACも血中濃度に影響しうるP糖蛋白やCYP3A4の誘導・阻害薬薬剤との併用には注意を要する．本稿では，現時点で得られているエビデンスをもとに，高齢心房細動患者のpolypharmacyに対する原則的な対応について，著者の考えを示した．
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鈴木 et al. (2022) conducted a review in Atrial fibrillation with polypharmacy in older patients. Anticoagulation therapy (DOACs and Warfarin) was evaluated. Polypharmacy in older patients with atrial fibrillation is associated with increased risks of bleeding and adverse events, necessitating careful selection and monitoring of anticoagulants such as DOACs.
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