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Studies of Anticoagulant Therapy in Frail Elderly Patients: Problems of Terminology and Methodology

https://doi.org/10.20996/1819-6446-2019-15-2-251-257

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Abstract

A recently published article [1 ] on the problems of anticoagulant therapy in patients with frailty syndrome contains two statements which highlight ri-varoxaban among other non-vitamin K antagonist oral anticoagulants (NOAC): 1) none of the randomized controlled trials (RCTs) with NOAC (except for two RCTs with rivaroxaban - EINSTEIN-DVT and EINSTEIN-PE) contained data on the participation of frail patients; 2) one of the studies of real clinical practice showed that only therapy with rivaroxaban (out of three NOAC) in comparison to warfarin reduced the risk of stroke/systemic embolism and ischemic stroke in frail elderly patients with atrial fibrillation after 2 years of observation. The paper presents a critical analysis of these statements showing that the first statement is based on the incorrect use of the collective term "fragility” as a synonym for the term "frailty”, whereas the second statement is based on the results of a study that has a number of serious methodological limitations.

About the Authors

S. N. Bel'diev
Tver State Medical University
Russian Federation

Sergey N. Bel'diev - MD, PhD, Associate Professor, Chair of Therapy and Cardiology.

Sovetskaya ul. 4, Tver, 170100


I. V. Medvedeva
Tver State Medical University
Russian Federation

Irina V Medvedeva - MD, PhD, Associate Professor, Chair of Therapy and Cardiology.

Sovetskaya ul. 4, Tver, 170100


D. Yu. Platonov
Tver State Medical University
Russian Federation

Dmitry Yu. Platonov - MD, PhD, MPH, Associate Professor, Head of Chair of Therapy and Cardiology.

Sovetskaya ul. 4, Tver, 170100



G. Yu. Trufanova
Tver State Medical University
Russian Federation

Galina Yu. Trufanova - MD, PhD, Associate Professor, Chair of Therapy and Cardiology.

Sovetskaya ul. 4, Tver, 170100



References

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For citation:


Bel'diev S.N., Medvedeva I.V., Platonov D.Y., Trufanova G.Y. Studies of Anticoagulant Therapy in Frail Elderly Patients: Problems of Terminology and Methodology. Rational Pharmacotherapy in Cardiology. 2019;15(2):251-257. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-2-251-257

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