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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

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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

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

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

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

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

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 citation:


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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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)