title: [Oral anticogulation for non-valvular atrial fibrilation in the elderly].
abstract: Anticoagulation in elderly people with non-valvular atrial afibrillation (AF) is a challenge, due to the thromboembolic, as well as the haemorrhagic risks. The correct use of anticoagulants in these patients has shown a higher net clinical benefit when comparing it with a younger population. Non-vitamin K antagonist oral anticoagulants (NOACs) have been compared to oral vitamin K antagonists in several studies that included a sufficient number of elderly people. Favourable results for non-vitamin K antagonist oral anticoagulants were obtained in these studies, making them the preferred treatment for this group of patients. Basing the estimations on indirect comparisons, the ideal anticoagulant and the specific dose for each particular case has been determined. Finally, a new algorithm has been developed that relates these parameters. Geriatric assessment is the key to the indication for an anticoagulation, the type of anticoagulant needed, and also the best way to optimise all the factors for a safe anticoagulation. The arrival of non-vitamin K antagonist oral anticoagulants will enhance the efficient thromboembolic prophylaxis rate in elderly people with AF. This new treatment will remove different controversial prophylaxis, such as antiaggregants.
authors.affiliation: Servicio de Geriatría, Hospital Universitario Lucus Augusti, Lugo, España. Electronic address: Fernando.veiga.fernandez@sergas.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Veiga Fernández
authors.affiliation: Servicio de Geriatría, Hospital Universitario Lucus Augusti, Lugo, España.
authors.forename: María del Rocío
authors.initials: Mdel R
authors.lastname: Malfeito Jiménez
authors.affiliation: Servicio de Geriatría, Hospital Universitario Lucus Augusti, Lugo, España.
authors.forename: Sonia María
authors.initials: SM
authors.lastname: Barros Cerviño
authors.affiliation: Servicio de Geriatría, Hospital Universitario Lucus Augusti, Lugo, España.
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Magariños Losada
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications*; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000517:prevention & control*; D013923:Thromboembolism / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: Anciano; Anticoagulantes orales no antagonistas de la vitamina K; Elderly; Fibrilación auricular no valvular; New oral anticoagulants; Non-valvular atrial fibrilation; Non-vitamin K antagonist oral anticoagulants; Nuevos anticoagulantes orales; Profilaxis tromboembólica en fibrilación auricular; Thromboembolic prophylaxis in atrial fibrillation.