Please use this identifier to cite or link to this item:
Title: Oral anticoagulant use and appropriateness in elderly patients with atrial fibrillation in complex clinical conditions: CONVENIENCE study
Author: Bonanad, Clara
Formiga Pérez, Francesc
Anguita, Manuel
Petidier, Roberto
Gullón, Alejandra
Keywords: Fibril·lació auricular
Anticoagulants (Medicina)
Persones grans dependents
Interaccions dels medicaments
Atrial fibrillation
Anticoagulants (Medicine)
Frail elderly
Drug interactions
Issue Date: 14-Dec-2022
Publisher: MDPI
Abstract: Non-valvular atrial fibrillation (NVAF) is the most common arrhythmia in older patients. Although direct-acting oral anticoagulants (DOAC) are the antithrombotic treatment of choice, irrespective of age, certain factors may limit their use. The aim of the ACONVENIENCE study was to consult the opinion of a multidisciplinary panel of experts on the appropriateness of using OACs in elderly patients (>75 years) with NVAF associated with certain complex clinical conditions. A consensus project was performed on the basis of a systematic review of the literature, and application of a two-round Delphi survey. The agreement of 79 panellists on 30 Delphi-type statements was evaluated, and their opinion on the appropriateness of different oral anticoagulants in 16 complex clinical scenarios was assessed. A total of 27 consensus statements were agreed upon, including all statements addressing anticoagulation in older patients and in patients at high risk of bleeding complications, and most of those addressing frailty, dementia, risk of falling, and complex cardiac situations. It was almost unanimously agreed upon that advanced age should not influence the anticoagulation decision. Apixaban was the highest-rated therapeutic option in 14/16 situations, followed by edoxaban. There is a high degree of agreement on anticoagulation in older patients with NVAF. Age should not be the single limiting factor when prescribing OACs, and the decision should be made based on net clinical benefit and a comprehensive geriatric assessment. Apixaban, followed by edoxaban, was considered the most appropriate treatment in the various complex clinical situations examined.
Note: Reproducció del document publicat a:
It is part of: Journal of Clinical Medicine, 2022, vol. 11
Related resource:
ISSN: 2077-0383
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Files in This Item:
File Description SizeFormat 
727414.pdf1.51 MBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons