Atrial Fibrillation and Stroke in Elderly Patients

Authors

Geetanjali Dang, Medical College of Wisconsin; Aurora Research InstituteFollow
Imaan Jahangir, Aurora Health Care
Jasbir Sra, Aurora Cardiovascular Services, Aurora Health CareFollow
A. Jamil Tajik, Aurora Cardiovascular Services, Aurora Health CareFollow
Arshad Jahangir, Sheikh Khalifa bin Hamad Al Thani Center for Integrative Research on Cardiovascular Aging, Aurora Research InstituteFollow

Publication Date

11-11-2016

Keywords

aging, warfarin, atrial fibrillation, antiplatelet agents, stroke, novel anticoagulant, atrial appendage occlusion

Abstract

The increasing prevalence of stroke, with an estimated annual cost of $71.5 billion, has made it a major health problem that increases disability and death, particularly in patients with atrial fibrillation. Although advanced age and atrial fibrillation are recognized as strong risk factors for stroke, the basis for this susceptibility are not well defined. Aging or associated diseases are accompanied by changes in rheostatic, humoral, metabolic and hemodynamic factors that may contribute more to stroke predisposition than rhythm abnormality alone. Several thromboembolism-predisposing clinical characteristics and serum biomarkers with prognostic significance have been identified in patients with atrial fibrillation. Although anticoagulation decreases the risk of thromboembolism, management in the elderly remains complex due to major concerns about bleeding. New anticoagulants and nonpharmacologic strategies are helpful to reduce the risk of bleeding, particularly in older-elderly patients. Herein, we review the pathogenesis and management of select issues of thromboembolism in the elderly with atrial fibrillation.

Recommended Citation

Dang G, Jahangir I, Sra J, Tajik AJ, Jahangir A. Atrial fibrillation and stroke in elderly patients. J Patient Cent Res Rev. 2016;3:217-29. doi: 10.17294/2330-0698.1409