Atrial Fibrillation at Elderly Age: The Importance of Stroke Prevention.
Atrial fibrillation increases in prevalence with advancing age and is the major precursor of embolic stroke in an elderly population. Currently about 2.2 million people in the United States have atrial fibrillation and their median age is 75 years. Patients older than 75 years of age with atrial fibrillation and those with underlying coronary heart disease or with heart failure are at highest risk of stroke. Long-term warfarin anticoagulant therapy, in a number of randomized controlled trials of its use in nonvalvular atrial fibrillation, substantially decreased stroke risk, with benefit maintained at elderly age. Warfarin anticoagulation at elderly age, with careful monitoring and attention to concomitant therapies, can be safely accomplished with an acceptably low rate of bleeding complication.
Wenger
Nanette K.
NK
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA.