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[Risk of chronic oral anticoagulant treatment in elderly patients]
S Braun1, G Chamorro, C Wilson
1Departamento de Enfermedades Cardiovasculares, Hospital Clínico, Pontificia Universidad Católica de Chile, Santiago.
Insights
Long term anticoagulation therapy is safe for elderly patients. This study found similar risks of bleeding and embolic complications in older adults compared to younger individuals, supporting its use in the elderly.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacology
Background:
- Long-term anticoagulation is crucial for preventing thromboembolic events.
- Age is a significant factor influencing medication risks and benefits.
- Limited data exists on age-specific risks associated with long-term anticoagulation.
Purpose of the Study:
- To evaluate the safety and efficacy of long-term anticoagulation in different age groups.
- To assess age-related risks of bleeding and embolic complications.
- To determine if elderly patients face increased risks during anticoagulation therapy.
Main Methods:
- Retrospective follow-up study of 348 patients at an anticoagulation clinic over seven years.
- Patients categorized into three age groups: under 56, 56-69, and over 70 years.
- Analysis of patient records for anticoagulation levels, bleeding, and embolic complications.
Main Results:
- Adequate anticoagulation (INR 2.2-4.5) was achieved in 64% of patients.
- Elderly patients exhibited slightly higher prothrombin times.
- Incidence of major bleeding (1.84/100 pt yrs) and embolic complications (1.93/100 pt yrs) did not significantly differ across age groups.
Conclusions:
- Long-term anticoagulation therapy can be safely administered to elderly patients.
- The risk of hemorrhagic and embolic complications is comparable between elderly and younger populations.
- This study supports the continued use of anticoagulation in the elderly with similar risk profiles.
Abstract:
To assess age-related risks of long term anticoagulation, the records of 348 patients followed up at our university hospital outpatient anticoagulation clinic during a seven year period were reviewed. There were 129 patients, under 56 years of age, 144 from 56 to 69 and 75 over 70 years old. The total observation period was 1089 patient-years (3.3 yrs per pt). 64% of the patients had adequate anticoagulation level (prothrombin time < 35%, INR 2.2-4.5) 70 to 100% of the observation period. Prothrombin time was slightly, but significantly higher in the elderly group. During this period 21 patients developed major bleeding complications (1.84/100 pt yrs), 8 of them with fatal intracranial hemorrhages, and 20 embolic complications (1.93/100 pt yrs), 3 of them fatal. No significant differences in the incidence of both bleeding and embolic complications were observed in the three groups. The results of this retrospective follow-up study suggest that long term anticoagulation can be carried out in elderly pts with risk of hemorrhagic and embolic complications similar to those observed in the general population.