TABLE 1.

Anticoagulation for Very Elderly AF Patients

1. Very elderly AF patients are at an increased risk of both stroke and bleeding, but the benefit of anticoagulation outweighs the risk of bleeding.

2. Warfarin and DOACs are both good options.

3. Renal function may dictate choice of anticoagulation.

4. Although there are no head-to-head trials, dabigatran 150 mg twice daily compared with warfarin was associated with an increased risk of extracranial bleeding in octogenarians, whereas apixaban was superior to warfarin in both efficacy and safety, independent of age.

5. Compliance is key, so patient comprehension and shared decision making are important.

AF = atrial fibrillation; DOAC = direct oral anticoagulants.