B. Leithäuser, F. Jung*, J.-W. Park
Asklepios Klinik Harburg, 1st Medical Department, Cardiology, Hamburg, Germany; *Center for Biomaterial Development and Berlin Brandenburg Center for Regenerative Therapies (BCRT), GKSS Research Center Geesthacht GmbH, Teltow, Germany
[Applied Cardiopulmonary Pathophysiology 13: 307-317]
Anticoagulation therapy for thromboembolism prophylaxis in patients with atrial fibrillation (AF) is based on quality information derived from numerous randomized controlled trials but continues to be a conundrum for many physicians. Age is the most cited argument to withhold anticoagulation. Ironically, because of their higher risk of stroke, the net benefit of antithrombotic therapy may be greater in octogenarians than in younger patients. Indeed, given the risk of major bleeding there is reason to be skeptical about net benefit when warfarin is used in some elderly patients with AF. This summary reviews the risks of cardioembolic stroke and bleeding in patients with atrial fibrillation with and without oral anticoagulation and spotlights the problematic nature of anticoagulation underuse in the elderly.
Key words: atrial fibrillation, thromboembolism, stroke, anticoagulants, risk, prognosis, aged
Address for corresponding:
Boris Leithäuser, M.D., 1st Medical Department, Cardiology, Asklepios Klinik Harburg, Eissendorfer Pferdeweg 52, 21075 Hamburg, Germany