Warfarin acceptable choice for some octogenarians with atrial fibrillation
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The prevalence of atrial fibrillation (AF) increases with age, occurring in 2% of adults 65 to 75 years old, 5% of adults older than 75 years, and 14% of adults older than 84. The presence of AF increases the risk of stroke in an individual by a factor of 4. AF is directly implicated in 14% of all strokes among patients older than 60—about 75,000 strokes per year in the United States. Anticoagulation therapy with warfarin is highly effective for reducing the risk of stroke, but carries a risk of serious bleeding complications and has significant monitoring costs. However, debate continues about the best approach for reducing strokes due to AF among the oldest elderly. Two recent clinical trials suggest that warfarin remains a reasonable choice for selected older adults.
Evidence Based Practice 11(1): 01-03.