Effectiveness and safety of oral anticoagulants in elderly patients with atrial fibrillation.

Objectives: To assess the risk of stroke/systemic embolism (SE) and major bleeding associated with the use of oral anticoagulants in elderly patients with atrial fibrillation (AF) in a real-world population.

Methods: We identified all anticoagulant-naive initiators of warfarin, dabigatran, rivaroxaban and apixaban for the indication AF in Norway between January 2013 and December 2017. Multivariate competing risk regression was used to calculate subhazard ratios (SHRs) describing associations between non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin for risk of stroke/SE and major bleeding.

New score for assessing bleeding risk in patients with atrial fibrillation treated with NOACs.

Background: Information is needed on bleeding risk factors specific for patients with atrial fibrillation (AF) treated with non-vitamin K oral anticoagulants (NOACs). We aimed to identify risk factors in a large real-world cohort and to derive a bleeding risk score for patients with AF treated with NOACs.

Methods: From nationwide registries (the Norwegian Patient Registry and the Norwegian Prescription Database), we identified patients with AF with a first prescription of a NOAC between January 2013 and June 2015.

New anticoagulants in combination with antiplatelet agents.

The use of new, direct anticoagulants is increasing. Data from both controlled trials and clinical practice have shown that these drugs are as efficacious and safe as warfarin for deep vein thrombosis and pulmonary embolism, and as stroke prophylaxis for patients with atrial fibrillation. But what if platelet inhibition is also indicated? In the following, the combination of antiplatelets and the new anticoagulants is discussed for various indications.