Stroke prevention in atrial fibrillation: putting the guidelines into practice.

Abstract:

:Atrial fibrillation confers a 5-fold increase in risk of stroke. A number of drugs aimed at reducing this risk have been tested in randomized controlled trials. These include antiplatelet agents (singly and in combination); anticoagulants, including vitamin K antagonists and direct thrombin inhibitors; and anticoagulants with antiplatelet agents. Guidelines recommend that the choice of therapy should be determined by an assessment of underlying risk of stroke, with antiplatelet agents being indicated for people at low risk of stroke and anticoagulants for those at higher risk. The treatment decision is complicated by considerations of haemorrhage risk, with factors that increase risk of stroke also associated with increased risk of haemorrhage. Evidence from recent studies confirms that patients at high risk of stroke should be treated with anticoagulants, including elderly patients, provided that good international normalized ratio (INR) control can be maintained. Newer agents may enable a higher proportion of patients at high risk of stroke to be treated with anticoagulants than is currently the case. Decision making about people at moderate risk of stroke is less clear cut, and a choice of either an antiplatelet agent or an anticoagulant can be justified. For people at low risk of stroke, anticoagulation is not indicated.

journal_name

Drugs Aging

journal_title

Drugs & aging

authors

Mant J,Edwards D

doi

10.2165/11538620-000000000-00000

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

859-70

issue

11

eissn

1170-229X

issn

1179-1969

pii

1

journal_volume

27

pub_type

杂志文章,评审
  • Positive Effects of a Sufficient Pre-fracture Serum Vitamin D Level on the Long-Term Survival of Hip Fracture Patients in Finland: A Minimum 11-Year Follow-Up.

    abstract:BACKGROUND:Several studies have shown that the mortality of elderly hip fracture patients is higher than that in the general population, and is higher in male than in female hip fracture patients. OBJECTIVE:The objective of this study was to investigate factors affecting overall mortality at a minimum of 11 years foll...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-015-0267-8

    authors: Nurmi-Lüthje I,Lüthje P,Kaukonen JP,Kataja M

    更新日期:2015-06-01 00:00:00

  • Inflammatory bowel disease in the elderly.

    abstract::Although inflammatory bowel disease (IBD) is generally considered a disease of young adults, it can occur in elderly individuals. The clinical features and treatment considerations in older patients are similar to those in younger patients, with some notable exceptions, which are reviewed in this article. Consideratio...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/11537340-000000000-00000

    authors: Hussain SW,Pardi DS

    更新日期:2010-08-01 00:00:00

  • Decitabine: a review of its use in older patients with acute myeloid leukaemia.

    abstract::Decitabine (Dacogen(®)) is a deoxynucleoside analogue of cytidine that selectively inhibits DNA methyltransferases. Decitabine administered at a dose of 20 mg/m(2) by a 1-h intravenous infusion for 5 consecutive days of a 4-week cycle has been approved by the European Medicines Agency (EMA) for use in adult patients a...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-013-0084-x

    authors: Curran MP

    更新日期:2013-06-01 00:00:00

  • Influenza vaccination in the elderly: impact on hospitalisation and mortality.

    abstract::Influenza causes substantial morbidity across the age spectrum. However, the elderly are especially vulnerable to the serious complications of influenza that might result in hospitalisation or death, and high rates of influenza-associated excess hospitalisation or death that exceed by several-fold the rates seen among...

    journal_title:Drugs & aging

    pub_type: 杂志文章,meta分析,评审

    doi:10.2165/00002512-200522060-00004

    authors: Nichol KL

    更新日期:2005-01-01 00:00:00

  • Drug-Drug Interactions and Prescription Appropriateness in Patients with COVID-19: A Retrospective Analysis from a Reference Hospital in Northern Italy.

    abstract:BACKGROUND:Patients hospitalised with severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2; coronavirus 2019 disease (COVID-19)] infection are frequently older with co-morbidities and receiving polypharmacy, all of which are known risk factors for drug-drug interactions (DDIs). The pharmacological burden may be ...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-020-00812-8

    authors: Cattaneo D,Pasina L,Maggioni AP,Giacomelli A,Oreni L,Covizzi A,Bradanini L,Schiuma M,Antinori S,Ridolfo A,Gervasoni C

    更新日期:2020-12-01 00:00:00

  • Suitable Use of Injectable Agents to Overcome Hypoglycemia Risk, Barriers, and Clinical Inertia in Community-Dwelling Older Adults with Type 2 Diabetes Mellitus.

    abstract::The management of type 2 diabetes mellitus in older adults requires a comprehensive understanding of the relationship between the disease (medical) and the functional, psychological/cognitive, and social geriatric domains, to individualize both glycemic targets and therapeutic approaches. Prevention of hypoglycemia is...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-019-00706-4

    authors: Valencia WM,Florez HJ,Palacio AM

    更新日期:2019-12-01 00:00:00

  • Use of Antibiotics in Chronic Obstructive Pulmonary Disease: What is Their Current Role in Older Patients?

    abstract::Chronic obstructive pulmonary disease (COPD) has considerable morbidity and mortality in the older adult population. The role of antibiotics in the management of acute exacerbations of COPD (AECOPD) is currently evolving. Despite only mild benefits, most patients with AECOPD in ambulatory settings receive antibiotics ...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-020-00786-7

    authors: Al-Hasan MN,Al-Jaghbeer MJ

    更新日期:2020-09-01 00:00:00

  • Advances in the pharmacological treatment of gastro-oesophageal cancer.

    abstract::Despite a sharp decline in the incidence of gastric cancer during the second half of the 20th century, this malignancy remains the second leading cause of cancer mortality in the world. The incidence and mortality rate of gastric cancer increase with age; at present, the median ages at diagnosis are 67 years for men a...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/11315740-000000000-00000

    authors: Wagner AD,Wedding U

    更新日期:2009-01-01 00:00:00

  • The clinical potential of matrix metalloproteinase inhibitors in the rheumatic disorders.

    abstract::Rheumatoid arthritis (RA) and osteoarthritis are chronic diseases that result in cartilage degradation and loss of joint function. Currently available drugs are predominantly directed towards the control of pain and/or the inflammation associated with joint synovitis but they do little to reduce joint destruction. In ...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200118020-00002

    authors: Elliott S,Cawston T

    更新日期:2001-01-01 00:00:00

  • Anticholinergic component of the Drug Burden Index and the Anticholinergic Drug Scale as measures of anticholinergic exposure in older people in New Zealand: a population-level study.

    abstract:BACKGROUND:Older people are exposed to multiple medicines that possess anticholinergic properties. The use of anticholinergic medicines is associated with the risk of morbidity, mortality and cognitive decline, particularly in older people. Anticholinergic exposure can be measured using tools such as the Drug Burden In...

    journal_title:Drugs & aging

    pub_type: 杂志文章

    doi:10.1007/s40266-013-0111-y

    authors: Narayan SW,Hilmer SN,Horsburgh S,Nishtala PS

    更新日期:2013-11-01 00:00:00

  • Anaesthesia for cataract surgery.

    abstract::Cataract surgery is the most frequent surgical procedure requiring anaesthesia in developed countries. It is performed mainly in elderly patients, who present with many coexisting diseases that induce subsequent hazards from general anaesthesia. Cataract anaesthesia is performed following various techniques of regiona...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/11318590-000000000-00000

    authors: Nouvellon E,Cuvillon P,Ripart J,Viel EJ

    更新日期:2010-01-01 00:00:00

  • Improving elder care by integrating geriatric expertise into medicare: a proposal.

    abstract::The Medicare programme already funds a large proportion of the medical care for older Americans. However, geriatricians are an underutilized resource for improving the quality of care delivered with Medicare funding, particularly to the most complex patients. Recent legislative changes will increase the involvement of...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200522050-00002

    authors: Nusbaum NJ

    更新日期:2005-01-01 00:00:00

  • Cost-effectiveness of pharmaceutical management for osteoarthritis pain: a systematic review of the literature and recommendations for future economic evaluation.

    abstract:BACKGROUND AND OBJECTIVE:Osteoarthritis (OA) is a highly prevalent and chronic condition characterized by pain and physical disability. Currently, many treatments are available, and they primarily target pain relief. The objectives of this study were to systematically review economic evaluations for pharmaceutical mana...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-013-0062-3

    authors: Xie F,Tanvejsilp P,Campbell K,Gaebel K

    更新日期:2013-05-01 00:00:00

  • Drug-induced seizures in the elderly. Causative agents and optimal management.

    abstract::We conducted a review of drugs that were most commonly associated with inducing seizures in the elderly population. The method for determining the risk of these agents includes evaluating the utilisation and the percentage of adverse events in previous studies and case reports. Classes of medications, such as anti-psy...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199507010-00005

    authors: Franson KL,Hay DP,Neppe V,Dahdal WY,Mirza WU,Grossberg GT,Chatel DM,Szwabo PA,Kotegal S

    更新日期:1995-07-01 00:00:00

  • Antidepressants and falls in the elderly.

    abstract::Antidepressants have long been recognized as a contributory factor to falls and many studies show an association between antidepressants and falls. There are extensive data for tricyclic antidepressants (TCAs) and related drugs, and for selective serotonin reuptake inhibitors (SSRIs), but few data for other classes of...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200926050-00002

    authors: Darowski A,Chambers SA,Chambers DJ

    更新日期:2009-01-01 00:00:00

  • Current evidence for neuroprotective effects of nicotine and caffeine against Parkinson's disease.

    abstract::Parkinson's disease (PD) is the second most common neurodegenerative disorder affecting 1 to 3% of individuals over the age of 65 years. While effective therapy exists for treating the bradykinesia, rigidity and tremor associated with the disease, the cause is unknown. There is no treatment available to prevent or slo...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200118110-00001

    authors: Ross GW,Petrovitch H

    更新日期:2001-01-01 00:00:00

  • Do Risk Prediction Models for Postoperative Delirium Consider Patients' Preoperative Medication Use?

    abstract:BACKGROUND:Medicines are potentially modifiable risk factors for postoperative delirium. However, the extent to which preoperative medicines are included in risk prediction models (RPMs) is unknown. OBJECTIVE:This systematic review aimed to assess the extent of inclusion of preoperative medications in RPMs for postope...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-018-0526-6

    authors: Kassie GM,Nguyen TA,Kalisch Ellett LM,Pratt NL,Roughead EE

    更新日期:2018-03-01 00:00:00

  • Acute cough in the elderly: aetiology, diagnosis and therapy.

    abstract::Although the frequency of physician consultations and the sale of over-the-counter remedies establish the high prevalence of acute cough in the elderly, epidemiological studies have tended to be imprecise. However, respiratory tract infections in nose, larynx and/or bronchi, either viral or bacterial or both, are by f...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200421040-00003

    authors: Widdicombe J,Kamath S

    更新日期:2004-01-01 00:00:00

  • Age-related endothelial dysfunction : potential implications for pharmacotherapy.

    abstract::Aging per se is associated with abnormalities of the vascular wall linked to both structural and functional changes that can take place at the level of the extracellular matrix, the vascular smooth muscle and the endothelium of blood vessels. Endothelial dysfunction is generally defined as a decrease in the capacity o...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200320070-00005

    authors: Matz RL,Andriantsitohaina R

    更新日期:2003-01-01 00:00:00

  • Late-Onset and Elderly Psoriatic Arthritis: Clinical Aspects and Management.

    abstract::Psoriatic arthritis (PsA) can start in subjects aged over 60 years, defined as late-onset PsA. In late-onset PsA, the weight of family history and genetic background appears less significant when compared with younger onset PsA, whereas obesity and smoking have been suggested as potential risk factors. In patients wit...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-019-00688-3

    authors: Caso F,Tasso M,Chimenti MS,Navarini L,Perricone C,Girolimetto N,Peluso R,Del Puente A,Afeltra A,Perricone R,Punzi L,Scarpa R,Costa L

    更新日期:2019-10-01 00:00:00

  • Effect of antihypertensive agents on quality of life in the elderly.

    abstract::Management of hypertension in the elderly should take into account, in particular, the possible negative impact of antihypertensive drugs on the patient's quality of life, the deterioration of which may result in a loss of independence and reduced treatment compliance. Quality of life is recognised as a multifactorial...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200421060-00003

    authors: Fogari R,Zoppi A

    更新日期:2004-01-01 00:00:00

  • Age-related changes in laboratory test results. Clinical implications.

    abstract::Many quantities assayed in clinical laboratories demonstrate age-related changes. Particularly important periods are early life, adolescence, old age, and after the menopause in females. The changes that occur until adulthood are well documented. Fewer data are available on elderly people even though they consume a la...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199303030-00006

    authors: Fraser CG

    更新日期:1993-05-01 00:00:00

  • Diagnostic and pharmacological approaches in Alzheimer's disease.

    abstract::Alzheimer's disease is a chronic progressive disease affecting higher intellectual functioning. The clinical diagnosis is made when the onset of illness is insidious, the course slowly progressive and all the treatable causes of dementia have been ruled out. The use of more stringent criteria has improved clinical dia...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199101020-00006

    authors: Hermann C,Stern RG,Losonzcy MF,Jaff S,Davidson M

    更新日期:1991-03-01 00:00:00

  • Disease-modifying antirheumatic drugs. Potential effects in older patients.

    abstract::Disease-modifying antirheumatic drugs (DMARDs) are frequently used in rheumatoid arthritis. A number of physiological changes occur in the elderly which may modify the use of these medications. The most commonly used DMARDs are antimalarial drugs (particularly hydroxychloroquine), sulfasalazine and methotrexate. The p...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199507060-00003

    authors: Gardner G,Furst DE

    更新日期:1995-12-01 00:00:00

  • The economic burden of glaucoma and ocular hypertension: implications for patient management: a review.

    abstract::This paper reviews the burden and economic consequences of glaucoma upon healthcare systems and patients, especially elderly patients. An extensive review of the literature was conducted, primarily using MEDLINE, but also by examining selected article reference lists, relevant websites and the proceedings of specialis...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200522040-00004

    authors: Rouland JF,Berdeaux G,Lafuma A

    更新日期:2005-01-01 00:00:00

  • Molecular rationale for the pharmacological treatment of Alzheimer's disease.

    abstract::Cerebral deposition of amyloid plaques containing amyloid beta-peptide (Abeta) has traditionally been considered the central feature of Alzheimer's disease (AD). Abeta is derived from amyloid precursor protein (APP), which is cleaved by several different proteases: alpha-, beta- and gamma-secretase. In the past decade...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-200522001-00003

    authors: Zimmermann M,Gardoni F,Di Luca M

    更新日期:2005-01-01 00:00:00

  • Etidronic acid. A review of its pharmacological properties and therapeutic efficacy in resorptive bone disease.

    abstract::Etidronic acid is an orally and intravenously active bisphosphonate, which is believed to inhibit resorption of bone via a number of cellular mechanisms, including alteration of osteoclastic activity. In studies of patients with symptomatic Paget's disease, etidronic acid 5 to 20 mg/kg/day administered orally rapidly ...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199405060-00006

    authors: Dunn CJ,Fitton A,Sorkin EM

    更新日期:1994-12-01 00:00:00

  • Aspirin and heparin in acute ischaemic stroke in older patients.

    abstract::Over four-fifths of all strokes are due to thrombotic or embolic occlusion of cerebral arteries. There is a strong rationale for considering antithrombotic therapy for the treatment of patients with acute ischaemic stroke. Antiplatelet therapy with 150 to 300 mg of aspirin (acetylsalicylic acid) started within the fir...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.2165/00002512-199915010-00003

    authors: Gubitz GJ,Sandercock PA

    更新日期:1999-07-01 00:00:00

  • Sedative load and mortality among residents of long-term care facilities: a prospective cohort study.

    abstract:BACKGROUND:Older people are often prescribed multiple drugs with sedative properties. Most research has focused on specific classes of sedative and psychotropic drugs. The cumulative effect of taking multiple drugs with sedative properties has been termed 'sedative load'. Few previous studies have investigated the seda...

    journal_title:Drugs & aging

    pub_type: 临床试验,杂志文章

    doi:10.2165/11317080-000000000-00000

    authors: Taipale HT,Bell JS,Soini H,Pitkälä KH

    更新日期:2009-01-01 00:00:00

  • Evidence-Based Management of Diabetes in Older Adults.

    abstract::The number of older adults with diabetes is rapidly increasing worldwide. A variety of factors contribute to the age-related increase in the incidence of diabetes. The lack of empiric evidence in the field has limited the management guidelines to mostly expert opinion. Given uncertainty over the rate at which to lower...

    journal_title:Drugs & aging

    pub_type: 杂志文章,评审

    doi:10.1007/s40266-018-0598-3

    authors: Mooradian AD

    更新日期:2018-12-01 00:00:00