Vedovati Maria Cristina, Agnelli Giancarlo
Internal Vascular and Emergency Medicine-Stroke Unit, University of Perugia, 06129 Perugia, Italy.
IRCCS Istituti Scientifici Maugeri, 27100 Pavia, Italy.
J Pers Med. 2022 Aug 20;12(8):1339. doi: 10.3390/jpm12081339.
Despite the recent advancements, oral anticoagulation is still challenging in some patients and this is the case for old and frail patients. The large majority of frail patients with atrial fibrillation should receive anticoagulation since the associated benefits outweigh the risk of bleeding. A multidisciplinary consensus document on the use and prescription of direct oral anticoagulants (DOACs) in older and frail patients with atrial fibrillation has been recently published. In this manuscript we provide a comment on this document and add insights into the management of these patients. The new DOAC age had imposed a paradigm shift in the management of patients with the need for clinically-oriented services rather than laboratory-oriented services. In this paper we provide tools for a structured patient-oriented DOACs treatment service supported by a multidisciplinary approach.
尽管最近有了进展，但口服抗凝治疗在一些患者中仍然具有挑战性，老年和体弱患者就是如此。绝大多数患有房颤的体弱患者都应接受抗凝治疗，因为相关益处大于出血风险。最近发表了一份关于老年和体弱房颤患者使用和处方直接口服抗凝剂（DOACs）的多学科共识文件。在本手稿中，我们对该文件发表评论，并补充对这些患者管理的见解。新的DOAC时代在需要临床导向服务而非实验室导向服务的患者管理中引发了范式转变。在本文中，我们提供了通过多学科方法支持的以患者为导向的结构化DOACs治疗服务工具。
