Bleeding risk in older adult patients with NVAF
NICE NG1962:
“Do not withhold anticoagulation solely based on a person’s age or their risk of falls”
Protecting your older patients with NVAF from stroke
Dr Joseph Kwan, Consultant in stroke medicine at Imperial College Healthcare NHS Trust, discusses the management of stroke prevention in older patients with NVAF
Not all patients are the same. What matters the most to you?
Use of rivaroxaban is not recommended in those with end stage renal impairment (creatinine clearance <15 ml/min). Rivaroxaban can be used in those with a creatinine clearance 15–29 ml/min, provided it is done with caution. Rivaroxaban should also be used with caution in patients with renal impairment concomitantly receiving other medicinal products which increase rivaroxaban plasma concentrations.
Footnotes
NVAF, non-valvular atrial fibrillation; DOAC, direct oral anticoagulant.
* Rivaroxaban is to be used with caution in patients with CrCl 15 - 29 ml/min and in patients with renal impairment concomitantly receiving other medicinal products which increase rivaroxaban plasma concentrations. Use is not recommended in patients with CrCl < 15 ml/min.
** based on prospective real-world evidence where elderly is defined as 80 years or older, SAFIR-AC. Results of ROCKET-AF elderly patient sub-analysis were consistent with overall ROCKET-AF study4,5.
References
- Hylek EM et al. Circulation 2007;29;115:2689–2696.
- NICE 2021 NG196. Available at: https://www.nice.org.uk/guidance/NG196 (Last Accessed March 2024)
- Tamayo S et al. Clin Cardiol 2015;38:63–68.
- Hanon O, et al. Heart 2021;107:1376–1382
- Patel M.R. et al. N Engl J Med 2011; 365;10
RP-XAR-GB-5139 | February 2024