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Current Geriatrics Reports
Erschienen in: Current Geriatrics Reports 4/2015

01.12.2015 | Cardiovascular Disease in the Elderly (DE Forman, Section Editor)

Conundrums for Atrial Fibrillation Management in Older Adults

verfasst von: Alexander C. Fanaroff, Tracy Y. Wang

Erschienen in: Current Geriatrics Reports | Ausgabe 4/2015

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Abstract

Atrial fibrillation (AF) afflicts over 33 million people worldwide, the large majority of them older than 65, and increases embolic stroke risk fourfold to fivefold. This stroke risk can be reduced by two thirds or more with anticoagulation, although this benefit is balanced by an increased risk of bleeding. Guidelines recommend use of the CHA2DS2-VASc risk score to estimate annual stroke risk and inform shared decision making between patients and providers. Although the net clinical benefit of anticoagulation for stroke prophylaxis in AF is well established in patients with CHA2DS2-VASc scores ≥2, anticoagulation remains underutilized, especially in older patients. While older patients are at higher risk for bleeding on anticoagulation, they also derive the most benefit from anticoagulation due to their higher stroke risk. In this review, benefits of warfarin and targeted oral anticoagulants will be discussed, and relative utility of these therapies for stroke prophylaxis will be clarified.
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Metadaten
Titel
Conundrums for Atrial Fibrillation Management in Older Adults
verfasst von
Alexander C. Fanaroff
Tracy Y. Wang
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Current Geriatrics Reports / Ausgabe 4/2015
Elektronische ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-015-0143-8

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