Complications of Warfarin Therapy in Older Adults: A Review

Atrial fibrillation prevalence increases with age and is the most common arrhythmia in clinical practice. 2 Approximately half of patients with atrial fibrillation in the United States are over the age of 75 years of age. Due to aging of the general population, the number of patients aged 80 years and older are increasing. Warfarin, a vitamin K antagonist, is the most effective antithrombotic available for stroke prevention associated with atrial fibrillation but has been associated with risk of hemorrhage. Warfarin is the second most common cause of adverse drug events in emergency departments, and the overall risk of major bleeding averages 7-8% peryear. 4 Recent randomized-control trials conducted to identify the risks of bleeding complications of warfarin therapy in the older, frail, vulnerable adult support the net benefit of warfarin anticoagulant therapy for older adults with atrial fibrillation.