Document Detail


Anticoagulation for atrial fibrillation in the elderly.
MedLine Citation:
PMID:  15785149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial fibrillation is a risk factor for stroke, particularly among elderly patients. Multiple trials have established that antithrombotic therapy decreases stroke risk. Aspirin is associated with a relative risk reduction of about 21% and adjusted-dose warfarin (international normalized ratio 2.0-3.0) is associated with a relative risk reduction of about 68%. Warfarin is more effective than aspirin but is used less often than indicated because of hemorrhagic risk and the inconvenience of coagulation monitoring. The oral direct thrombin ximelagatran has been investigated for stroke prevention in patients with atrial fibrillation in two large clinical trials. The results suggest efficacy in a fixed dose compared with well controlled warfarin. Although anticoagulation intensity was not monitored or regulated during treatment with ximelagatran, it was associated with less bleeding than warfarin. Other antithrombotic agents are under development as alternatives to warfarin, but sufficient data are not yet available to justify their clinical use in patients with atrial fibrillation.
Authors:
Jonathan L Halperin
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of geriatric cardiology     Volume:  14     ISSN:  1076-7460     ISO Abbreviation:  Am J Geriatr Cardiol     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-03-23     Completed Date:  2005-06-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9215283     Medline TA:  Am J Geriatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  IM    
Affiliation:
The Zena and Michael A. Wiener Cardiovascular Institute, The Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, Fifth Avenue at 100th Street, New York, NY 10029, USA. jonathan.halperin@msnyuhealth.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticoagulants / therapeutic use*
Aspirin / therapeutic use
Atrial Fibrillation / complications,  drug therapy*
Azetidines / therapeutic use
Benzylamines
Humans
International Normalized Ratio
Randomized Controlled Trials as Topic
Risk Factors
Stroke / etiology,  prevention & control*
Warfarin / therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Azetidines; 0/Benzylamines; 0/ximelagatran; 50-78-2/Aspirin; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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