Abstract

MCLEOD, Christopher J  and  GERSH, Bernard J. Anticoagulation in the elderly patient with atrial fibrillation. Rev.Urug.Cardiol. [online]. 2015, vol.30, n.3, pp.385-396. ISSN 0797-0048.

Increasing age stands out as one of the most powerful risk factors for stroke in patients with atrial fibrillation. With the steadily increasing age of the global population, questions regarding the optimal anticoagulation strategy in the elderly are pervasive and often present highly complex clinical dilemmas. This group of patients is at increased risk of bleeding related to multiple other comorbidities, higher rates of falling, and polypharmacy -especially the anti-platelet agents. The elderly patient is more sensitive to warfarin, and coupled with higher rates of intracranial bleeding, the newer anticoagulants present an attractive alternative in selected subgroups. This review is aimed at contextualizing the problem, and providing a practical, balanced approach to managing the inescapable predicament of bleeding versus thromboembolic stroke in this high-risk group.

Keywords : ATRIAL FIBRILLATION; ANTICOAGULANTS; AGED.

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