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Implications of the Presence of Frailty Syndrome in Oral Anticoagulation by Atrial Fibrillation: Evaluating the Evidence

Miguel Angel Acosta-Benito, Spain

Introduction: frailty is a geriatric syndrome that identifies individuals with a greater probability of getting sick and suffering secondary events, also in relation to medication. If frail people use anticoagulants may have greater risk of bleeding. We aim to analyze the evidence available on the influence of frailty on anticoagulation in patients with atrial fibrillation. Materials and methods: a review of the literature was made through a search in Medline Database. Two independent investigators reviewed and selected the articles and resumed the principal topics. Results: 14 articles were selected. Anticoagulation is safe frail patients with good therapeutic compliance. Most studies support the use of non vitamin K inhibitors due to a lower risk of bleeding. Conclusions: frail elderly with AF should receive anticoagulation if there isn't any contraindication. New anticoagulants are preferable to warfarin for their better safety profile. New studies have to be developed to improve level of evidence.

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