Abstract
The new oral anticoagulants (NOACs) dabigatran etexilate, rivaroxaban, and apixaban have been extensively studied for prevention and treatment of venous thromboembolic disease and for stroke prevention in atrial fibrillation. Elderly patients have the highest incidence of thrombotic complications but also have the highest risk of anticoagulant associated bleeding. In this review we critically examine the balance between risks and benefits of NOACs compared with vitamin K antagonists in elderly patients enrolled in phase 3 randomized controlled trials for the management of venous thrombosis and stroke prevention in atrial fibrillation. Results show that the favourable balance between risks and benefits of NOACs is preserved in the elderly population.
Keywords:
anticoagulants; apixaban; atrial fibrillation; dabigatran etexilate; elderly; rivaroxaban; stroke; venous thromboembolism; vitamin K antagonists.
© 2013 Elsevier Ltd. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Administration, Oral
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Aged
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Anticoagulants / therapeutic use*
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Atrial Fibrillation / complications
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Atrial Fibrillation / pathology*
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Benzimidazoles / therapeutic use*
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Dabigatran
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Drug Administration Schedule
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Humans
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Intracranial Hemorrhages / chemically induced
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Intracranial Hemorrhages / prevention & control
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Morpholines / therapeutic use*
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Pyrazoles / therapeutic use*
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Pyridines / therapeutic use*
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Pyridones / therapeutic use*
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Randomized Controlled Trials as Topic
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Rivaroxaban
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Stroke / etiology
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Stroke / pathology
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Stroke / prevention & control*
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Thiophenes / therapeutic use*
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Venous Thromboembolism / etiology
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Venous Thromboembolism / pathology
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Venous Thromboembolism / prevention & control*
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Vitamin K / antagonists & inhibitors
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Warfarin / therapeutic use
Substances
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Anticoagulants
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Benzimidazoles
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Morpholines
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Pyrazoles
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Pyridines
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Pyridones
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Thiophenes
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Vitamin K
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apixaban
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Warfarin
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Rivaroxaban
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Dabigatran