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[Oral anticoagulants in the elderly].
M Debray1, E Pautas, P Couturier
1Département de médecine gériatrique et communautaire, centre hospitalier universitaire, 38043 cedex 09, Grenoble, France. matthieu.debray@ujf-grenoble.fr <matthieu.debray@ujf-grenoble.fr>
La Revue De Medecine Interne
|March 26, 2003
Summary
Oral anticoagulation is underused in the elderly despite its benefits for atrial fibrillation and venous thromboembolism. Strategies to optimize the benefit-risk ratio and minimize bleeding complications are crucial for safe and effective treatment.
Area of Science:
- Geriatrics
- Cardiology
- Pharmacology
Context:
- Atrial fibrillation and venous thromboembolism are prevalent in the elderly, posing significant clinical challenges.
- Oral anticoagulation offers proven benefits in reducing thromboembolic events but is underutilized in this demographic.
- Balancing the benefits of anticoagulation against the increased risk of bleeding in older adults is a critical clinical consideration.
Purpose:
- To review the indications for oral anticoagulation in the elderly.
- To analyze the benefit-risk ratio of oral anticoagulation in older adults.
- To propose strategies for minimizing bleeding risks associated with oral anticoagulation in the elderly.
Summary:
- Oral anticoagulation effectively reduces the risk of systemic thromboembolism in nonvalvular atrial fibrillation, with risk increasing with age.
- Elderly patients face a higher risk of major bleeding complications, necessitating careful risk assessment and management.
- Comprehensive geriatric evaluation and specialized anticoagulation clinics can aid in decision-making and safe management.
Impact:
- Informing clinical practice regarding the appropriate use of oral anticoagulation in the elderly.
- Providing evidence-based strategies to enhance the safety and efficacy of anticoagulation therapy in older patients.
- Highlighting the importance of personalized treatment approaches, considering individual patient factors and frailty.