Antithrombotic management of atrial fibrillation in the elderly.

Older patients with atrial fibrillation have an increased risk of stroke and systemic embolism compare with younger patients. For most patients, oral anticoagulation remains the most effective way to reduce this risk. Although vitamin K antagonists have been used for decades, the more recent development of non-vitamin K-dependent oral anticoagulants provides clinicians with a broader selection of anticoagulants for stroke prevention in older patients with AF. This article discusses stroke risk-stratification tools for clinical decision making, reviews pharmacologic options for the prevention of stroke, and highlights several practical considerations to the use of these agents in older adults.