Les Nouveaux Anti-Coagulant Oraux (NACOs) Apportent-ils des avantages par rapport aux antivitamines K dans la prévention des accidents vasculaires cérébraux lors d’une fibrillation auriculaire pour les personnes de plus de 75 ans ?
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- Atrial fibrillation increases the risk of ischaemic stroke. This is an arterial thrombosis that can leave serious neurological sequelae such as hemiplegia, communication problems and impaired cognitive function. This leads to a real impairment of social and family life. Vitamin K antagonists (VKAs), led by warfarin, are the gold standard for stroke prevention. They inhibit several clotting factors II, VII, IX and X. In addition, they are inexpensive substances. On the other hand, they require a rather complicated treatment plan, especially for an elderly person. Monthly blood tests and dietary changes affect the quality of life of the senior citizen. Although direct oral anticoagulants (DOACs) offer ease of use and greater comfort for the elderly, they represent a heavy financial burden. These relatively new molecules are the subject of several clinical studies to compare them with warfarin. However, in my work, I wanted to evaluate the efficacy and safety of AODs compared to warfarin in a very specific subpopulation, which is the 75 years and older. For this purpose, the results of the different experimental and observational studies were analysed and compared with each other to be able to conclude whether AODs provide added value compared to VKAs