Pharmacokinetics of direct oral anticoagulants in the elderly and senile

Purpose. To study the prevalence of complications associated with the use of direct oral anticoagulants (DOAC) in geriatric patients with polypragmasia and coordinity of atrial fibrillation (AF) and chronic kidney disease (CKD).

Material and methods. The study was attended by 113 elderly and senile patients with polymorbity who received an outpatient basis as AF therapy: apixban (n = 23), rivaroxaban (n = 54) and dabigatran (n = 36).

Results. It is shown that hemorrhagic complications (only “small” bleeding were considered, of which > 90% were found mainly in the first year of taking DOAC. At the same time, the frequency of complications increased with age, with a decrease in the stage of CKD, especially when taking dabigatran (whose elimination is 80% depends on the kidneys). The number of drugs taken in our examination did not increase the likelihood of bleeding, but some combinations were identified in which the risk of hemorrhagic complications was statistically significantly higher: metoprolol and rivaroxaban (r = 0.35); verapamil and dabigatran (r = 0.25).