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Anticoagulant Therapy in Patients Aged 80 Years or More With Atrial FibrillationMore Caution Is Needed
Richard J. Ackermann, MD
Arch Fam Med. 1997;6(2):105-110.
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IN THE December 1995 issue of the ARCHIVES, Lackner and Battis1 assessed the appropriate use of anticoagulant therapy with warfarin sodium (Coumadin, DuPont Pharma, Wilmington, Del) in a small study of 69 nursing home residents (mean age, 88 years) with chronic nonvalvular atrial fibrillation (NVAF). They found that only 12 (17%) of these patients were taking warfarin, and made a strong argument that this was far too few. In an accompanying Editorial in that issue, Brechtelsbauer2 generally agreed that elderly patients with atrial fibrillation (AF) should receive oral anticoagulant therapy to reduce the risk of stroke unless a contraindication exists. Several other authorities, including the American College of Chest Physicians' Fourth Consensus Conference on Antithrombotic Therapy have recently supported this position,3-11 although there have been voices of caution.12-16 I suggest that oral anticoagulant therapy to prevent stroke in very old (age >80 years) patients with NVAF
. . . [Full Text PDF of this Article]
Author Affiliations
Department of Family and Community Medicine Mercer University School of Medicine Macon, Ga
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