Rutherford OCW, Jonasson C, Ghanima W, et al. - This study was undertaken to investigate the risk of stroke/systemic embolism (SE) and major bleeding associated with the use of oral anticoagulants in elderly patients with atrial fibrillation (AF) in a real-world population. Between January 2013 and December 2017, researchers distinguished all anticoagulant-naive initiators of warfarin, dabigatran, rivaroxaban, and apixaban for the indication of AF in Norway. They used multivariate competing risk regression to estimate sub hazard ratios describing relationships between non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin for risk of stroke/SE and major bleeding. They included 30,401 patients ≥ 75 years (median age 82 years, 53% women, mean CHA2DS2-VaSc score 4.5), 3,857 initiated dabigatran, 6,108 rivaroxaban, 13,786 apixaban, and 6,650 warfarin. Standard and reduced dose NOACs were associated with similar risks of stroke/SE as warfarin and lower or similar risks of bleeding in this nationwide cohort study of patients ≥ 75 years initiating oral anticoagulation for AF. As per the findings, the NOACs appear to be a safe option also in elderly patients.