title: Non-vitamin K oral anticoagulant treatment in elderly patients with atrial fibrillation and coronary heart disease.
abstract: Atrial fibrillation (AF) is the most frequent sustained arrhythmia. Overall prevalence is estimated to 5.5% and the incidence increases with age. As the population ages, the prevalence and costs of AF are expected to increase. AF is the most important cause of stroke in patients >75years. Until recently, Vitamin K antagonists (VKAs) were the only available oral anticoagulants (OACs) evaluated for long-term treatment of patients with AF with or without coronary heart disease (CHD). This situation was challenged by introduction of non-VKA oral anticoagulants (NOACs). In AF, use of NOACs seems to be as effective and safe as VKAs, especially in elderly patients. AF and CHD are frequently associated and the question of antithrombotic management in aging patients is delicate. In elderly patients experiencing a new AF episode after an acute coronary syndrome, triple antithrombotic therapy should be as short as possible in order to decrease the risk of major bleedings. To date, there is no specific study or available guidelines regarding the NOACs use specifically in elderly patients experiencing both AF and CHD. In this review, we try to provide a perspective on NOACs future incorporation into clinical practice in elderly patients with both AF and CHD.
authors: Normandie Univ, UNICAEN, Department of General Medicine, Medical School, 14000 Caen, France; CHU de Caen, Department of Pharmacology, Caen, F-14033, France.
authors: Xavier
authors: X
authors: Humbert
authors: CHU de Caen, Department of Cardiology, Caen, F-14033, France.
authors: Vincent
authors: V
authors: Roule
authors: CHU de Caen, Department of Cardiology, Caen, F-14033, France.
authors: Mathieu
authors: M
authors: Chequel
authors: CHU de Caen, Department of Pharmacology, Caen, F-14033, France; Normandie Univ, UNICAEN, CHU Caen, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000 Caen, France.
authors: Sophie
authors: S
authors: Fedrizzi
authors: CHU de Caen, Department of Hematology, Caen, F-14033, France.
authors: Marie
authors: M
authors: Brionne
authors: CHU de Caen, Department of Pharmacology, Caen, F-14033, France; Normandie Univ, UNICAEN, CHU Caen, Inserm U 1075 COMETE, 14000 Caen, France.
authors: Véronique
authors: V
authors: Lelong-Boulouard
authors: CHU de Caen, Department of Cardiology, Caen, F-14033, France; Normandie Univ, UNICAEN, CHU Caen, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000 Caen, France.
authors: Paul
authors: P
authors: Milliez
authors: CHU de Caen, Department of Pharmacology, Caen, F-14033, France; CHU de Caen, Department of Cardiology, Caen, F-14033, France; Normandie Univ, UNICAEN, CHU Caen, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000 Caen, France. Electronic address: alexandre-j@chu-caen.fr.
authors: Joachim
authors: J
authors: Alexandre
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D014812:Vitamin K
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Atrial fibrillation; Coronary heart disease; Elderly patients; Non-VKA oral anticoagulants; Oral anticoagulant