Direct oral anticoagulants in patients with atrial fibrillation and renal impairment, extremes in weight, or advanced age. Issue 1 (7th October 2016)

• Record Type: Journal Article
• Authors: Buckley, Leo F.; Rybak, Eva; Aldemerdash, Ahmed; Cheng, Judy W.M.; Fanikos, John
• Is Part Of: Clinical cardiology. Volume 40:Issue 1(2017)
• Page Start: 46
• Page End: 52
• Publication Date: 2016-10-07
• Subjects: direct oral anticoagulants -- stroke prevention -- atrial fibrillation -- chronic kidney disease -- obesity -- advanced age; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.22591
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : A growing number of patients with an indication for stroke prevention in atrial fibrillation have kidney‐, age‐, or weight‐related alterations in pharmacokinetics that affect dosing of direct oral anticoagulants. Because these patients were excluded from or comprised a small number of patients in clinical trials, there is a lack of evidence to guide clinicians. As a consequence, many patients do not receive oral anticoagulation despite a high risk for atrial fibrillation–related stroke. Here, we present a review of direct oral anticoagulant pharmacokinetics and a review of the available clinical evidence in patients with weight‐, kidney‐, and age‐related disease.