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KMID : 1011920150160040184
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International Journal of Arrhythmia
2015 Volume.16 No. 4 p.184 ~ p.192
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Early Experience of New Oral Anticoagulants for Stroke Prevention in Octogenarian Patients with Atrial Fibrillation
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Nam Gi-Byoung
Kim Min-Su
Kwon Chang-Hee
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Abstract
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Background and Objectives: The safety of new oral anticoagulants (NOACs) depends largely on renal function. As renal function deteriorates with aging, the safety of NOACs is clinically important for very old cardiac patients. This study analyzed the efficacy and safety of NOACs prescribed to an octogenarian population in a university hospital.
Subject and Methods: A total of 158 consecutive patients aged ≥80 years and who had been prescribed NOACs for non-valvular atrial fibrillation (54 patients on dabigatran, 104 patients on rivaroxaban) were included. Demographic features, laboratory findings, and clinical follow-up results were retrospectively reviewed.
Results: Reduced doses were prescribed in 105 (66.2%) patients. The estimated GFR curve in octogenarian patients shifted left compared to that of patients aged <80 years. There were two strokes or systemic embolic events during the follow-up period of 276 days. Major bleeding occurred in 13 patients, where gastrointestinal bleeding and anemia of unknown origin were the major causes.
Conclusion: NOACs seem to be highly effective for the prevention of stroke or systemic embolism in octogenarian populations. Bleeding events occurred in a considerable number of the study patients. Further studies on optimum dose ranges are required for very old subjects.
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KEYWORD
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Atrial Fibrillation, Stroke, Embolism, Bleeding, Anticoagulants
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