Key result
Direct oral anticoagulants showed significant advantages over warfarin in elderly patients with geriatric syndromes, with apixaban identified as the safest option (FORTA-A safety class).
Why the study?
Do direct oral anticoagulants provide advantages over warfarin in elderly patients with atrial fibrillation or venous thromboembolism and geriatric syndromes?
Do direct oral anticoagulants provide advantages over warfarin in elderly patients with atrial fibrillation or venous thromboembolism and geriatric syndromes?
Direct oral anticoagulants, particularly apixaban, offer significant advantages and improved safety over warfarin in elderly patients with atrial fibrillation and geriatric syndromes.
The administration of oral anticoagulants in elderly patients with geriatric syndromes such as senile asthenia syndrome, falls and high risk of falls, dementia, polymorbidity, polypharmacy are discussed in the article. The evidence base for the anticoagulants taking in patients with atrial fibrillation aged ≥75, ≥80, ≥85 and ≥90 years, in patients with atrial fibrillation and various geriatric syndromes, as well as in elderly patients with venous thromboembolic complications and frailty syndrome is presented. Most studies indicate significant advantages of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban) over the vitamin K antagonist warfarin in elderly patients with geriatric syndromes. An updated version of the FORTA consensus document, which aims to optimize the prescription of medicines for the elderly, is also presented. Apixaban has a FORTA-A safety class and is the safest oral anticoagulant in elderly patients.
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N. M. Vorobyeva (2020) conducted a review in Atrial fibrillation and venous thromboembolic complications. Direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban) vs. Vitamin K antagonist warfarin was evaluated. Direct oral anticoagulants showed significant advantages over warfarin in elderly patients with geriatric syndromes, with apixaban identified as the safest option (FORTA-A safety class).
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