In the last twelve years the clinical management of patients with atrial fibrillation has been revolutionised by the introduction of direct oral anticoagulants. Despite the large amount of evidence produced, some populations remain relatively poorly explored regarding the effectiveness and safety of direct oral anticoagulants, such as the oldest and/or frailest individuals. Frailty is clinical syndrome characterized by a reduction of functions and physiological reserves which results in individuals having higher vulnerability. While current evidence underlines a relationship between atrial fibrillation and frailty, particularly in determining a higher risk of adverse outcomes, data regarding effectiveness and safety of direct oral anticoagulants in frailty atrial fibrillation patients are still lacking, leaving uncertainty about how to guide prescription in this specific subgroup. On these premises, this multidisciplinary consensus document explains why it would be useful to integrate the clinical evaluation performed through comprehensive geriatric assessment to gather further elements to guide prescription of direct oral anticoagulants in such a high-risk group of patients.

Proietti, M., Camera, M., Gallieni, M., Gianturco, L., Gidaro, A., Piemontese, C., et al. (2022). Use and Prescription of Direct Oral Anticoagulants in Older and Frail Patients with Atrial Fibrillation: A Multidisciplinary Consensus Document. JOURNAL OF PERSONALIZED MEDICINE, 12(3) [10.3390/jpm12030469].

Use and Prescription of Direct Oral Anticoagulants in Older and Frail Patients with Atrial Fibrillation: A Multidisciplinary Consensus Document

Bellelli, Giuseppe
Co-ultimo
;
2022

Abstract

In the last twelve years the clinical management of patients with atrial fibrillation has been revolutionised by the introduction of direct oral anticoagulants. Despite the large amount of evidence produced, some populations remain relatively poorly explored regarding the effectiveness and safety of direct oral anticoagulants, such as the oldest and/or frailest individuals. Frailty is clinical syndrome characterized by a reduction of functions and physiological reserves which results in individuals having higher vulnerability. While current evidence underlines a relationship between atrial fibrillation and frailty, particularly in determining a higher risk of adverse outcomes, data regarding effectiveness and safety of direct oral anticoagulants in frailty atrial fibrillation patients are still lacking, leaving uncertainty about how to guide prescription in this specific subgroup. On these premises, this multidisciplinary consensus document explains why it would be useful to integrate the clinical evaluation performed through comprehensive geriatric assessment to gather further elements to guide prescription of direct oral anticoagulants in such a high-risk group of patients.
Articolo in rivista - Articolo scientifico
atrial fibrillation; bleeding; cardiovascular prevention; DOAC; frailty; old age; stroke;
English
Proietti, M., Camera, M., Gallieni, M., Gianturco, L., Gidaro, A., Piemontese, C., et al. (2022). Use and Prescription of Direct Oral Anticoagulants in Older and Frail Patients with Atrial Fibrillation: A Multidisciplinary Consensus Document. JOURNAL OF PERSONALIZED MEDICINE, 12(3) [10.3390/jpm12030469].
Proietti, M; Camera, M; Gallieni, M; Gianturco, L; Gidaro, A; Piemontese, C; Pizzetti, G; Redaelli, F; Scimeca, B; Tadeo, C; Cesari, M; Bellelli, G; Dalla Vecchia, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/361404
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