Safety of Non-Vitamin K Oral Anticoagulants in Elderly Patients with Atrial Fibrillation
https://doi.org/10.20996/1819-6446-2019-15-6-802-805
Abstract
Aim. To study the safety of non-vitamin K oral anticoagulants (NOAC) in patients with atrial fibrillation (AF) over 75 years old.
Material and methods. The observation study included patients ≥75 years of age with confirmed AF, receiving dabigatran in a reduced dosage, apixaban or rivaroxaban in full or reduced dosage. Previous experience of NOAC treatment from the very beginning of therapy, if a patient was ≥75 years old, or from the point a patient reached 75 years was considered; episodes of NOAK change, as well as hemorrhagic and ischemic events associated with taking an anticoagulant, were recorded. Patient groups were comparable in risk score by CHA2DS2-VASc and HAS-BLED scales.
Results. Patients with AF (n=102; 39 men and 63 women; an average age 79.4Ѓ}4.1 years) were included: 32 patients were in dabigatran group, 34 patients – in apixaban group and 36 patients – in rivaroxaban group. 19 clinically significant bleedings were recorded, 10 occurred in patients taking dabigatran and 9 in those taking rivaroxaban. No hemorrhagic events in patients treated with apixaban were observed. Hematuria (31.6%), large subcutaneous hematomas (26.3%) and intensive nasal bleedings (26.3%) were the most frequent events. No ischemic cardioembolic stroke was recorded.
Conclusions. In elderly patients, all NOAC (dabigatran, rivaroxaban and apixaban) demonstrated good safety profile without major bleeding within a 1.5-year follow-up period.About the Authors
M. A. Gabitova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Mariia A. Gabitova – MD, Assistant Professor, Chair of Faculty Therapy №1
Trubetskaya ul. 8-2, Moscow, 119991
P. M. Krupenin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Pavel M. Krupenin – MD, Resident, Chair of Nervous Diseases and Neurosurgery
Trubetskaya ul. 8-2, Moscow, 119991
A. A. Sokolova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anastasiya A. Sokolova – MD, PhD, Associate Professor, Chair of Faculty Therapy №1
Trubetskaya ul. 8-2, Moscow, 119991
D. A. Napalkov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Dmitry A. Napalkov – MD, PhD, Professor, Chair of Faculty Therapy №1
Trubetskaya ul. 8-2, Moscow, 119991
V. V. Fomin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Victor V. Fomin – MD, PhD, Professor, Corresponding Member of the Russian Academy of Science, Head of Chair of Faculty Therapy №1
Trubetskaya ul. 8-2, Moscow, 119991
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For citations:
Gabitova M.A., Krupenin P.M., Sokolova A.A., Napalkov D.A., Fomin V.V. Safety of Non-Vitamin K Oral Anticoagulants in Elderly Patients with Atrial Fibrillation. Rational Pharmacotherapy in Cardiology. 2019;15(6):802-805. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-6-802-805
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