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• Atrial fibrillation increases in occurrence as we age with about 9% of patients developing it by age 90. When a patient is diagnosed with atrial fibrillation, one of the drugs that they are prescribed is an anticoagulant. The purpose of this drug is to prevent thrombus formation in addition to preventing an ischemic stroke. Today, there are many options available for anticoagulation therapy. The options include aspirin, vitamin K antagonists like warfarin, factor Xa inhibitors like rivaroxaban and apixaban, direct thrombin inhibitors like dabigatran, and antiplatelet agents such as clopidogrel.
• A review of the literature was done of peer reviewed journal articles using the databases PubMed, Dynamed, CINAHL and Clinical Key. A total of 14 articles were used in this paper with the inclusion criteria of being published within the past five years, the patients all have atrial fibrillation, over 65 years old, and are on some form of anticoagulation therapy.
• Previously, warfarin has been one of the few anticoagulation drugs on the market until the newer novel anticoagulants were released. Bell et al. (2016) found that warfarin is still used in 53.6% of the patients, even though the prevalence has decreased by 3.9% between the years of 2011 and 2013. (p
• It was found that patients who were diagnosed with atrial fibrillation needed some form of anticoagulation as compared to no anticoagulation to reduce stroke. Most of the studies compared warfarin versus no anticoagulation treatment. There were not many studies that looked at the newer novel anticoagulants. It was mentioned that there has been a decrease in warfarin use since the newer novel anticoagulants have been released. There are considerations that a prescriber needs to be conscious of before prescribing a specific anticoagulant. Some of these considerations are renal function, other medication usage to avoid drug-drug interactions and age.
Physician Assistant Studies
Master of Physician Assistant Studies (MPAS)
Aged; Anticoagulants -- therapeutic use; Atrial Fibrillation -- drug therapy; Comparative Study
Hoistad, Rebecca, "Anticoagulation Therapy for the Elderly with Atrial Fibrillation" (2017). Physician Assistant Scholarly Project Posters. 41.