Managing older people with atrial fibrillation and preventing stroke: a review of anticoagulation approaches.
Leona A VermaPeter E PensonAsangaedem AkpanGregory Yoke Hong LipDeirdre A LanePublished in: Expert review of cardiovascular therapy (2023)
Non-vitamin K antagonist OACs are the preferred first-line OAC in older adults with AF, including high-risk subpopulations, after individual assessment of stroke and bleeding risk, except those with mechanical heart valves and moderate-to-severe mitral stenosis. Head-to-head comparisons of NOACs are not available, therefore the choice of drug (and dose) should be based on an individual's risk (stroke and bleeding) and incorporate their treatment preferences. Treatment decisions must be person-centered and principles of shared decision-making applied.
Keyphrases
- atrial fibrillation
- oral anticoagulants
- left atrial
- catheter ablation
- left atrial appendage
- direct oral anticoagulants
- heart failure
- percutaneous coronary intervention
- mitral valve
- emergency department
- left ventricular
- physical activity
- high intensity
- decision making
- replacement therapy
- adverse drug
- optical coherence tomography
- aortic valve replacement
- combination therapy
- brain injury
- venous thromboembolism
- cerebral ischemia
- electronic health record