Fast Five Quiz: Anticoagulation in Older Patients With Atrial Fibrillation

Sandeep K. Goyal, MD


March 09, 2022

The risk-benefit assessment of anticoagulation for patients with AF is influenced by advancing age. According to Shah and colleagues, the net clinical benefit of anticoagulation decreases with increasing age, and the importance of competing risks should be included in discussions of benefits and harms of anticoagulation therapy for older adults with AF. Individuals 75 years of age or older are at high risk for stroke. Patients aged 90 years or older may retain a net clinical benefit with oral anticoagulation, and its use should be considered for AF management. Oral anticoagulation may still be considered for very old patients, and NOACs may be a more favorable choice. The prevalence of cerebral microbleeds is higher in older patients, and their presence increases the risk for intracerebral hemorrhage; however, anticoagulation therapy should not be withheld purely because of their presence.

Learn more about the risks and benefits of anticoagulation.


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