title: [Anticoagulant therapy with dabigatran in elderly patients ≥80 years of age with atrial fibrillation].
abstract: OBJECTIVE
  Atrial fibrillation is a potent risk factor for stroke, and the administration of anticoagulant therapy is important for preventing thromboembolism. Dabigatran is the first new oral anticoagulant developed as an alternative to warfarin. However, serious major gastrointestinal bleeding events have been observed in elderly patients in post-market case reports. We therefore retrospectively investigated elderly cases of the use of anticoagulant therapy with dabigatran.
  
  
  METHODS
  Twenty-eight patients over 80 years of age were treated with anticoagulant therapy at our satellite hospital. Nine of the patients received dabigatran, and all others received warfarin. We evaluated the CHADS2 score, HAS-BLED score, renal function and incidence of adverse effects in nine patients treated with dabigatran.
  
  
  RESULTS
  All of the nine patients received 220 mg/day of dabigatran, with no antiplatelet agents. Seven patients continued to receive dabigatran. One patient had an impaired renal function (Cr 1.55 mg/dl, Ccr 30 ml/min). However, the activated partial thromboplastin time (APTT) was not prolonged and neither major bleeding nor stroke were noted in seven patients. Although two patients were unable to continue dabigatran treatment due to APTT prolongation, no serious complications were observed during the administration of dabigatran.
  
  
  CONCLUSIONS
  No serious adverse effects of dabigatran anticoagulant therapy were detected in our elderly patients. Although it is necessary to monitor the risk of bleeding, renal dysfunction, effects of drug combination and so on, some elderly patients with atrial fibrillation are good candidates for dabigatran treatment.
authors.affiliation: Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine.
authors.forename: Tamami
authors.initials: T
authors.lastname: Kono
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.forename: Jun
authors.initials: J
authors.lastname: Aono
authors.forename: Takafumi
authors.initials: T
authors.lastname: Okura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
mesh_terms: D000369:Aged, 80 and over; D000991:Antithrombins / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000378:metabolism; D000069604:Dabigatran / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013925:Thromboplastin / Q000378:metabolism
chemical_list: D000991:Antithrombins; D013925:Thromboplastin; D000069604:Dabigatran