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Advantages and disadvantages of direct oral anticoagulants in older patients

Antonio Cherubini, Barbara Carrieri, Paolo Marinelli
  • Antonio Cherubini
    Geriatric Emergency Care and Research Center on Aging, IRCCS-INRCA, Ancona, Italy | a.cherubini@inrca.it
  • Barbara Carrieri
    Geriatric Emergency Care and Research Center on Aging, IRCCS-INRCA, Ancona; Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
  • Paolo Marinelli
    Geriatric Emergency Care and Research Center on Aging, IRCCS-INRCA, Ancona; Department of Experimental Medicine And Public Health, University of Camerino, Camerino (MC), Italy

Abstract

Atrial fibrillation (AF) and venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, are conditions that increase with age. Anticoagulant therapy is strongly recommended both in patients with AF for the prevention of cardioembolic stroke, and for treatment of VTE and prevention of recurrent VTE. Until recently, vitamin K antagonists (VKAs) were the only oral drugs for long-term anticoagulation. In the past decade, four direct oral anticoagulants (DOACs) were approved: a direct thrombin inhibitor (dabigatran) and three factor Xa inhibitors (apixaban, rivaroxaban, edoxaban). Despite increasing evidence demonstrating the efficacy and safety of DOACs in older patients, there are still gray areas where the use of VKAs might be valuable.

Keywords

Vitamin K antagonist; direct oral anticoagulant; prevention; thrombosis; bleeding risk.

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Submitted: 2017-12-07 15:07:42
Published: 2018-03-28 10:50:11
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Copyright (c) 2018 Antonio Cherubini, Barbara Carrieri, Paolo Marinelli

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