Hemostasis Today

Paschalis Karakasis: Anticoagulation Management in Frail Older Adults
Jul 31, 2026, 13:19

Paschalis Karakasis: Anticoagulation Management in Frail Older Adults

Paschalis Karakasis, Cardiologist, Doctor of Philosophy at Aristotle University of Thessaloniki (AUTH), shared a post on LinkedIn about his recent article, published in European Heart Journal, adding:

“I am pleased to share a new publication in the European Heart Journal

‘To switch or not to switch: rethinking anticoagulation in frail elderly patients’

This article addresses an increasingly relevant clinical question: should frail older patients with atrial fibrillation who remain clinically stable on warfarin be routinely switched to a direct oral anticoagulant?

Although DOACs are generally preferred in contemporary practice, replacing an effective and well-tolerated anticoagulation strategy is not necessarily a neutral intervention. Decisions should account for anticoagulation quality, renal function, frailty, bleeding risk, adherence, appropriate dosing, and the individual reasons prompting a treatment change.

The key message is that treatment decisions should not be driven solely by therapeutic novelty.

In frail elderly patients who are doing well on warfarin, individualized assessment remains essential: the best anticoagulant is not necessarily the newer one, but the one that best fits the patient.”

Title: To switch or not to switch: rethinking anticoagulation in frail elderly patients

Authors: Paschalis Karakasis

Paschalis Karakasis: Anticoagulation Management in Frail Older Adults

Stay updated on all scientific advances with Hemostasis Today.