Studies of Anticoagulant Therapy in Frail Elderly Patients: Problems of Terminology and Methodology
Abstract
A recently published article (Rational Pharmacotherapy in Cardiology 2018;6:908-16) on the problems of anticoagulant therapy in patients with frailty syndrome contains two statements which highlight rivaroxaban among other non-vitamin K antagonist oral anticoagulants (NOAC): 1) none of the randomized controlled trials (RCTs) with NOAC (except for two RCTs with rivaroxaban – EINSTEIN-DVT and EINSTEIN-PE) contained data on the participation of frail patients; 2) one of the studies of real clinical practice showed that only therapy with rivaroxaban (out of three NOAC) in comparison to warfarin reduced the risk of stroke / systemic embolism and ischemic stroke in frail elderly patients with atrial fibrillation after 2 years of observation. The paper presents a critical analysis of these statements showing that the first statement is based on the incorrect use of the collective term “fragility” as a synonym for the term “frailty”, whereas the second statement is based on the results of a study that has a number of serious methodological limitations.
About the Authors
Sergey N. Bel'dievRussian Federation
Chair of Therapy and Cardiology, Associate Professor
Irina V. Medvedeva
Russian Federation
Chair of Therapy and Cardiology, Associate Professor
Dmitry Yu. Platonov
Russian Federation
Chair of Therapy and Cardiology, Head
Galina Yu. Trufanova
Russian Federation
Chair of Therapy and Cardiology, Associate Professor
References
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Supplementary files
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1. Рисунок 1. Эффективность и безопасность ППОАК по сравнению с варфарином у «хрупких» пациентов с ФП | |
| Subject | ||
| Type | Исследовательские инструменты | |
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For citations:
Bel'diev S.N., Medvedeva I.V., Platonov D.Yu., Trufanova G.Yu. Studies of Anticoagulant Therapy in Frail Elderly Patients: Problems of Terminology and Methodology. Rational Pharmacotherapy in Cardiology. 2019;15(2).
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