Stroke prevention in the elderly atrial fibrillation patient with comorbid conditions: focus on non-vitamin K antagonist oral anticoagulants

Abstract

Stroke prevention in elderly atrial fibrillation patients remains a challenge. There is a high risk of stroke and systemic thromboembolism but also a high risk of bleeding if anticoagulants are prescribed. The elderly have increased chronic kidney disease, coronary artery disease, polypharmacy, and overall frailty. For all these reasons, anticoagulant use is underutilized in the elderly. In this manuscript, the benefits of non-vitamin K antagonist oral anticoagulants compared with warfarin in the elderly patient population with multiple comorbid conditions are reviewed.

Keywords:

• non-vitamin K antagonist oral anticoagulants
• novel oral anticoagulants
• warfarin
• dabigatran
• rivaroxaban
• apixaban
• edoxaban

Disclosure

MK Turagam and P Velagapudi have no conflicts of interest to disclose. GC Flaker is a consultant for Bristol-Myers Squibb, Pfizer, Janssen, and Daiichi-Sanyko.