| Title |
Risk versus Benefit of Non-Vitamin K Dependent Anticoagulants Compared to Warfarin for the Management of Atrial Fibrillation in the Elderly
|
|---|---|
| Published in |
Drugs & Aging, April 2013
|
| DOI | 10.1007/s40266-013-0075-y |
| Pubmed ID | |
| Authors |
Kelechi C. Ogbonna, Sean M. Jeffery |
| Abstract |
The objective of this review was to compare the safety and efficacy of dabigatran, rivaroxaban and apixaban to warfarin for the management of atrial fibrillation (AF) in older adults. The prevalence and incidence of AF increase with age. Approximately 5 % of the United States population over the age of sixty-five years and 10 % over the age of seventy-nine years have AF. AF is associated with increased risk for thromboembolic events. Despite the increasing incidence and prevalence of AF in older adults and the risks of thromboembolic events, clinicians often avoid anticoagulants. Specifically with warfarin, the risk of hemorrhage may outweigh the benefit in stroke risk reduction in certain populations. Aspirin, while safer to use, is not as effective as warfarin in stroke risk reduction. Newer non-vitamin K dependent antithrombotic therapies (e.g. dabigatran, rivaroxaban, and apixaban) are redefining thromboprophylaxis of AF. Dabigatran, rivaroxaban, and apixaban are at least as effective as warfarin in stroke risk reduction. With new mechanisms of action and no need for therapeutic drug monitoring, countless new patients are potential candidates for anticoagulation. However patient adherence, lack of a reversal agent, cost, and other safety concerns remain reasons for caution and careful consideration. Furthermore, older adults exhibited greater adverse effects from these agents across the clinical trials. This review will examine the newer anticoagulants safety and efficacy with particular attention to their role in treating older adults with AF. Alternatives to warfarin therapy now exist for thromboprophylaxis of AF. Whether these agents represent advances in overall safety in older adults remains uncertain. More experience and research are needed before endorsing their widespread use as a replacement for warfarin in the geriatric population. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 3 | 50% |
| Unknown | 3 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 67% |
| Practitioners (doctors, other healthcare professionals) | 2 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 117 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 2% |
| Colombia | 1 | <1% |
| Slovenia | 1 | <1% |
| Brazil | 1 | <1% |
| Spain | 1 | <1% |
| Denmark | 1 | <1% |
| Unknown | 110 | 94% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 18 | 15% |
| Student > Master | 18 | 15% |
| Student > Bachelor | 15 | 13% |
| Student > Ph. D. Student | 10 | 9% |
| Student > Doctoral Student | 9 | 8% |
| Other | 31 | 26% |
| Unknown | 16 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 53 | 45% |
| Pharmacology, Toxicology and Pharmaceutical Science | 12 | 10% |
| Agricultural and Biological Sciences | 6 | 5% |
| Psychology | 5 | 4% |
| Nursing and Health Professions | 4 | 3% |
| Other | 16 | 14% |
| Unknown | 21 | 18% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 April 2013.
All research outputs
#7,096,061
of 22,708,120 outputs
Outputs from Drugs & Aging
#489
of 1,192 outputs
Outputs of similar age
#61,943
of 197,532 outputs
Outputs of similar age from Drugs & Aging
#5
of 19 outputs
Altmetric has tracked 22,708,120 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 1,192 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has gotten more attention than average, scoring higher than 59% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 197,532 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 73% of its contemporaries.